Diabetes: Complications and Mortality in Older Patients

Elbert S. Huang, MD MPH FACP Associate Professor of Medicine University of Chicago 5841 S. Maryland Ave., MC 2007 Chicago, IL 60637MedicalResearch.com Interview with:
Elbert S. Huang, MD MPH FACP
Associate Professor of Medicine
University of Chicago
5841 S. Maryland Ave., MC 2007
Chicago, IL 60637

MedicalResearch.com: What did you find most surprising in these results?

Dr. Huang: We did not expect hypoglycemia to rank as highly as it did among the diabetes complications.

We were also surprised to find that the rates of cardiovascular and microvascular complications are all dramatically lower than they were in the 1990s.

MedicalResearch.com: What factors do you consider in individualizing the treatment plan for a given patient?

Dr. Huang: Apart from age and duration of diabetes, it is important to consider the overall health status of the patient including their comorbid illnesses and functional status. These variables affect the likelihood that a patient will benefit from intensive glucose control and affect their ability to carry out the treatment plan. And of course, you have to consider the goals and preferences of the patient. Are they someone already bothered by the burdens of polypharmacy? Are they someone willing to do anything possible to prevent the complications of diabetes?

MedicalResearch.com: What main message would you hope for physicians to take away from this research?

Dr. Huang: When you meet an older patient with diabetes for the first time, the course of the disease will be different depending on their age and how long they have had the disease. Patients over 80 with longstanding diabetes are at the highest risk for experiencing the complications of diabetes as well as the side effects of treatment. Take time to ensure that hypoglycemia is avoided.

Citation:

Rates of Complications and Mortality in Older Patients With Diabetes Mellitus: The Diabetes and Aging Study.

Huang ES, Laiteerapong N, Liu JY, John PM, Moffet HH, Karter AJ.
JAMA Intern Med. 2013 Dec 9. doi: 10.1001/jamainternmed.2013.12956.
[Epub ahead of print]