Journal of the Indian Academy of Geriatrics (Jan 2017)
Vascular Complications of Type 2 Diabetes Mellitus among Elderly: Study at a Tertiary Health Care Centre in the Sub-Himalayan Region
Abstract
Objective: To study the frequency of macrovascular and microvascular complications in elderly with type 2 diabetes mellitus and its correlation with major cardiovascular risk factors. Research Design and Methods: 64 patients attending outpatient clinic who fulfilled the inclusion criteria of age more than 60 years with type 2 diabetes were studied during one year. Vascular complications and their risk factors were identified using a standardized questionnaire, blood and urine analysis. Results: The mean age of the patients was 67.62 ± 5.05 years. Middle age onset diabetes was seen in 43.75% of the study group, while 56.25% had elderly onset diabetes. The most prevalent cardiovascular risk factor was dyslipidemia (75.00%) followed by hypertension (71.87%), smoking (37.50%) and obesity (34.37%). Coronary artery disease, cerebrovascular disease and peripheral vascular disease were seen in 17.19%, 17.19% and 12.50% respectively, while diabetic retinopathy, diabetic nephropathy and neuropathy was seen in 31.25%, 25.00% and 28.13% respectively. 45.31% had no vascular complications. As compared to elderly onset diabetes those with middle age onset diabetes had higher mean HbA1C levels(8.94% vs 7.96%) and more prevalence of obesity (42.86% vs 27.78%), dyslipidemia (85.71% vs 66.67%), macro vascular (39.29% vs 25.00%) and micro vascular complications (50.00% vs 33.33%). Conclusion: The longer duration of diabetes and presence of multiple cardiovascular risk factors in elderly with type 2 diabetes mellitus makes them susceptible to vascular complications thereby increasing morbidity and mortality. Moreover, middle age and elderly onset diabetes appear to be two distinct groups with a difference in burden of cardiovascular risk factors and vascular complications. Future studies of diabetes in elderly may need to consider such difference while defining the treatment goals for this group.
