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Age and Ageing Advance Access originally published online on November 13, 2008
Age and Ageing 2009 38(1):56-62; doi:10.1093/ageing/afn218
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© The Author 2008. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Undetected type 2 diabetes in older adults

Rachel Dankner1,2, Galit Geulayov1, Liraz Olmer1 and Giora Kaplan1

1 The Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Israel
2 Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

Address correspondence to: Dr Rachel Dankner, Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer 52621, Israel. Tel: (+972) 3 5305173; Fax: (+972) 3 5349607. Email: racheld{at}gertner.health.gov.il

Background: early detection and prompt treatment of type 2 diabetes mellitus (T2D) may reduce the complications and burden associated with the disease.

Objective: to evaluate the rate of undetected T2D (UT2D) among older adults who were screened 25 years ago, identify the characteristics of UT2D patients and suggest a high-risk profile most suitable for screening.

Methods: a cross-sectional study of a group of 623 older adult survivors of 25-year cohort, 53.5% males, aged 58– 93 years in a personal interview on lifestyle habits, morbidity and medication use. Self-administered measurement of subjective health perception. Anthropometric measurements, laboratory examinations of 12-h fasting venous blood and 2-h oral glucose tolerance tests were carried out.

Results: the prevalence of previously diagnosed diabetes was 18.9% and of UT2D 13.2%. The likelihood of having UT2D was higher for males, those with systolic blood pressure ≥130 mmHg, triglycerides ≥1.7 mmol/l (150 mg/dl) and large waist circumference; all are components of the metabolic syndrome. Compared to known diabetic patients, the undetected were predominantly males, slightly younger, rated their health status more favourably and had less comorbidities.

Conclusion: a large proportion of older adults with T2D were undiagnosed. Screening efforts for T2D should address those exhibiting characteristics of the metabolic syndrome in a seemingly healthy population of older adults.

Keywords: detection, type 2 diabetes, risk profile, screening, subjective health, elderly

Received 8 September 2007; accepted in revised form 13 May 2008.


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