Risk factors of new onset diabetes mellitus among elderly Chinese in rural Taiwan

摘要

SIR—Diabetes mellitus (DM) is associated with a strongnnegative impact on the health care system, directly causingn5.2% of all deaths in the world [1]. Certain risk factors forndeveloping DM have been identified, including older age [2].nAmong all ethnic groups studied so far, the prevalence ofnDM may reach 20% in older people [3–5], and older diabeticnpatients are more likely to develop diabetic microangiopathy,natherosclerotic vascular diseases [5] and to die fromDM[6, 7].nThey are also more likely to develop cardiovascular diseasesnthan younger diabetic patients or non-diabetic elderly peoplen[5, 8]. Moreover, older diabetic patients are more prone tonhave physical disabilities, cognitive impairment and depressionn[9]. Accurate diagnosis and appropriate interventionnprogrammes for older diabetic patients may successfully preventnDM-related complications [10–12]. However, evidencensupporting current diagnostic criteria, prevention strategiesnand targets for glycaemic control in the older populationnare not fully developed [13, 14]. Tight glycaemic controlnmay successfully reduce the risk of microvascular andnmacrovascular complications in adults [15], but we lack evidencenthat these effects are relevant in the older population.nFor example, older men with late onset DM had similar mortalitynto non-diabetic subjects in long-term follow-up [16].nThus, strategies regarding diagnosis, screening and treatmentnin later onset DM remain controversial.