Classification of Diabetes in Older Adults

Older adults with diabetes mellitus are a heterogeneous group including juvenile- and adult-onset type I (insulindependent) diabetic patients and type II (non-insulindependent) diabetic patients, with some who are insulin requiring because of symptomatic hyperglycemia. Most older adults with newly diagnosed diabetes have type II diabetes, but the classification of patients into type I and type II diabetes is uncertain in most studies because only clinical characteristics are used. Age and weight at diagnosis are of value in classification of patients, whereas presence or absence of ketonuria at diagnosis has been shown to be of limited value. Measurements of C-peptide after stimulation appear to be the most reliable parameter in the classification of diabetes into type I or type II and with regard to whether a type II diabetic patient is insulin requiring.