title: Multiple complications and frequent severe hypoglycaemia in 'elderly' and 'old' patients with Type 1 diabetes.
abstract: OBJECTIVE
  Elderly and old patients with Type 1 diabetes represent a growing population that requires thorough diabetes care. The increasing relevance of this subgroup, however, plays only a minor role in the literature. Here, we describe elderly patients with Type 1 diabetes on the basis of a large multi-centre database in order to point out special features of this population.
  
  
  METHODS
  Data of 64609 patients with Type 1 diabetes treated by 350 qualified diabetes treatment centres were assessed and analysed by age group.
  
  
  RESULTS
  Compared with the age group ≤ 60 years, patients aged >60 years (n=3610 61-80 years and n=377 >80 years old) were characterized by a longer diabetes duration (27.7 vs. 7.7 years), an almost double risk for severe hypoglycaemia (40.1 vs. 24.3/100 patient-years), a lower level of HbA(1c) [60 vs. 67 mmol/mol (7.6 vs. 8.3%)] and higher percentages of microalbuminuria (34.5 vs. 15.6%), diabetic retinopathy (45.2 vs. 8.3%), myocardial infarction (9.0 vs. 0.4%) or stroke (6.8 vs. 0.3%). Elderly patients used insulin pumps less frequently (12.2 vs. 23.8%), but more often used conventional premixed insulin treatment (10.8 vs. 3.8%). Differences between elderly and younger patient groups were significant, respectively.
  
  
  CONCLUSIONS
  Diabetes care of elderly patients with Type 1 diabetes involves individualized treatment concepts. Increased hypoglycaemia risk and functional impairment attributable to diabetes-associated and/or age-related disorders must be taken into account.
authors.affiliation: Department of Internal Medicine I, University of Lübeck, Lübeck, Germany. morten.schuett@uk-sh.de
authors.forename: M
authors.initials: M
authors.lastname: Schütt
authors.forename: E-M
authors.initials: EM
authors.lastname: Fach
authors.forename: J
authors.initials: J
authors.lastname: Seufert
authors.forename: W
authors.initials: W
authors.lastname: Kerner
authors.forename: W
authors.initials: W
authors.lastname: Lang
authors.forename: A
authors.initials: A
authors.lastname: Zeyfang
authors.forename: R
authors.initials: R
authors.lastname: Welp
authors.forename: R W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000009:adverse effects; D007328:Insulin / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin