[Diabetes mellitus in elderly: comorbid characteristics of patients with different ontogenetic forms of the disease].
Diabetes in elderly is the interdisciplinary problem of diabetology and gerontology. Unlike adults the specific feature of these patients is comorbidities. On the other hand well known is the influence both age and aging on clinical sings of diabetes. The aim of the study was to investigate prevalence and structure comorbid chronic diseases in elderly patients with different ontogenetic forms of diabetes mellitus type 2 (DM2). We examined 169 elderly women with clinical diagnosis "DM2" (mean age--69.8 yrs., mean BMI--29.5 kg/m2, mean HbA1c--7.03%). The stratification was made by ontogenetic stage of diabetes onset and there were five ontogenetic forms of DM2: menstrual (Ms), early-postmenopausal (EPM), late-postmenopausal (LPM), early-involutional (EI) and late-involutional (LI). Anthropometrical, biochemical and immunochemical assays (HbA1c) were made by standard methods. Gognitive index (CGI) and affective index (AFI) were calculated by SCAG scale as mentalmnestic and affective disturbances accordingly. Comorbid index (CI) was calculated as a sum of concomitant diseases. The most comorbid serious was the early-postmenopausal group (CI--6.04 +/- 0.5), mainly by hypertension (92%) coronary heart disease (80%) and osteoarthritis (80%). The lightest comorbid status was in the late-involutional group (CI--4.5 +/- 0.3), with the minimum of gastroenterological diseases (39.5%), kidney diseases (26.3%), thyroid disorders (23.7%) and exclusively the group had valid negative relationship between age and CI (r = -0.550, p = 0.000). As a whole in the elderly diabetic cohort the magnitude of CI correlated positively with BMI (r = +0.344, p = 0.000), frequency of family diabetes (r = +0.204, p = 0.009), AFI (r = +0.161, p = 0.040), menarche (r = +0.175, p = 0.025) and no significantly with CGI (p > 0.05). Thus early ontogenetic forms of DM2 had more comorbidities, especially those with onset DM2 during first 5 years after menopause. And on the contrary, the latest ontogenetic forms with onset DM2 during 20 years after menopause had minimum concomitant diseases. Also early ontogenetic phase (EPM and El) groups had higher magnitudes of CI, frequency of family diabetes and low frequency of familial longevity than late ontogenetic phase (LPM and LI) groups, which allow us to consider early ontogenetic phase DM2 as a phenomena of accelerated aging.
Odin
V I
VI
Belikova
T V
TV
Shustov
S B
SB
Pushkova
E S
ES
Emanuél'
V L
VL