Impact of glucose level on morbidity and mortality in elderly with diabetes and pre-diabetes

doi:10.4239/wjd.v6.i2.345

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World Journal of Diabetes

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1948-9358

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World J Diabetes. Mar 15, 2015; 6(2): 345-351
Published online Mar 15, 2015. doi: 10.4239/wjd.v6.i2.345

Impact of glucose level on morbidity and mortality in elderly with diabetes and pre-diabetes

Orit Twito, Meir Frankel, Dan Nabriski

Orit Twito, Meir Frankel, Dan Nabriski, Endocrinology, Diabetes and Metabolism Institute, Meir Medical Center, Kfar Saba 44281, Israel

Author contributions: Twito O proposed the initial idea of the paper, wrote part of the paper and read and approved the final manuscript; Frankel M wrote part of the paper, and read and approved the final manuscript; Nabriski D made critical revisions, and read and approved the final manuscript.

Conflict-of-interest: The authors declare that they have no competing interests.

Correspondence to: Dr. Orit Twito, Endocrinology, Diabetes and Metabolism Institute, Meir Medical Center, 59 Tschernihovsky, St., Kfar Saba 44281, Israel. orit.twito@clalit.org.il

Telephone: +972-9-7472788 Fax: +972-9-7471644

Received: August 28, 2014
Peer-review started: August 28, 2014
First decision: September 19, 2014
Revised: October 30, 2014
Accepted: December 29, 2014
Article in press: December 31, 2014
Published online: March 15, 2015
Processing time: 203 Days and 4.4 Hours

Core Tip

Core tip: The prevalence of diabetes mellitus (DM) and pre-diabetes in old age is very high. However, clinical guidelines do not provide complete information to the clinician managing patients with these conditions. Pre-diabetes status in the elderly increases the risk for DM, but probably does not increase the risk of cardiovascular morbidity and mortality. The role of therapeutic interventions in elderly patients with pre-diabetes is not yet proven. New-onset DM in older age is associated with better glycemic control and better prognosis compared to long standing DM in this population. Nevertheless, higher glucose levels in elderly with new-onset DM are associated with increased all-cause mortality. The benefits of tight glycemic control in elderly with long standing DM are doubtful and may cause more harm than good. To conclude, more research in this field is needed. Currently, the clinical approach for DM and pre-diabetes in the elderly should be tailored to meet individual needs.