Living Long with Diabetes

Older type 2 diabetes patients have strong survival rates

(RxWiki News) Being diagnosed with diabetes is not a death sentence. While there is no cure for the condition, there are treatments that can prevent and delay the complications of diabetes, even in elderly people.

Middle-aged and elderly diabetes patients have a high rate of survival, even if they are living in nursing homes or have multiple health problems that make it hard to self-manage their disease.

These findings suggest that older adults can benefit from treatments to prevent or slow complications such as heart disease and kidney disease.

"Get treated for diabetes, no matter your age."

Before the study began, the researchers thought that older diabetes patients with dementia and other disabilities would have a high death rate, explains Christine T. Cigolle, M.D., M.P.H., of the University of Michigan Medical School and lead author of the study. However, all age groups had strong survival rates, except for patients over the age of 76 with the worst health.

People with type 2 diabetes are faced with a variety of complications, including eye and nerve damage, amputation, heart disease, and kidney disease. Fortunately, these complications can be prevented through treatment.

According to Dr. Cigolle, the success of treatment depends on two things: the patient's ability to self-manage their diabetes and living long enough for the benefits of treatment to set in.

The study's results show that older patients, who are more likely to have poor health, are also more likely to have trouble controlling their diabetes. However, a larger number of middle-aged patients had self-management difficulties.

Some of the more common self-management difficulties included blindness, cognitive impairment, and having multiple diseases that call for multiple drug treatments.

Another finding from the study shows that patients with some of the largest barriers to self-management were likely to live as long as five years. This finding suggests that older patients should be included in future studies to see if their outcomes are similar to those of younger and healthier diabetes patients.

When it comes to treating elderly patients, one difficulty has been figuring out which treatments are fitting, explains Caroline S. Blaum, M.D., M.S., of the University of Michigan and senior author of the study.

"The fact that this group is showing substantial survival means they may well be candidates for continued aggressive care," she says.

For their research, Dr. Cigolle and colleagues studied 3,507 diabetes patients 51 years of age and older. These middle-aged and older adults were categorized into three groups: a relatively healthy group, a group with barriers to self-management, and a group with poor health.

The results show that the five-year chance of survival was 90.8 percent for the relatively healthy group, 79.4 percent for the group with self-management difficulties, and 52.5 percent for the group with poor health.

The survival rate was more than 50 percent for all age groups, with the exception of those in the poor health group 76 years of age and older.

According to the authors, "These findings have implications for the clinical management of and future research about diabetes patients with multiple comorbidities."

The research was funded by the National Institutes of Health; the Claude D. Pepper Older Americans Independence Center at the University of Michigan; the John A. Hartford Foundation Center of Excellence in Geriatrics at the University of Michigan; and the Ann Arbor VA Geriatric Research, Education, and Clinical Center.

The study is published in the Journal of Gerontology.

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Review Date: 
May 2, 2012