Undetected type 2 diabetes in older adults.
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 >or=130 mmHg, triglycerides >or=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.


CONCLUSIONS
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.
Dankner
Rachel
R
The Gertner Institute for Epidemiology and Health Policy Research, Tel-Hashomer, Israel. racheld@gertner.health.gov.il
Geulayov
Galit
G
Olmer
Liraz
L
Kaplan
Giora
G
D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis; D015228:Hypertriglyceridemia / Q000150:complications / Q000175:diagnosis; D007407:Interviews as Topic; D007557:Israel / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D024821:Metabolic Syndrome / Q000150:complications / Q000175:diagnosis; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000175:diagnosis; D015995:Prevalence; D012307:Risk Factors