Older adults vary in age of onset and duration of diabetes (DM) but are treated similarly. We hypothesized that age of DM-onset has differential impact on distal outcome risk.

0057e analyzed waves 1993-2014 of the Health and Retirement Study, a nationally-representative health survey where we can study people before and after DM diagnosis for ∼ 20 years. Our sample included adults >50 years (n=27,975) without DM at entry. Age of DM-onset was defined as age when respondent first reported DM diagnosis. We classified adults who developed DM into 3 groups: <65, 65-75, >75. For each group, we constructed a propensity-score-matched control group of respondents who never develop DM. We compared risks of outcomes for each onset-age group and control: cardiac disease, stroke, mild disability (1-2 ADL/IADL dependencies), severe disability (>2 ADL/IADL dependencies), death.

At <65 years 1,283 respondents developed diabetes, 1,440 at 65-75, and 1,149 at >75; 21,994 never developed DM. Adults diagnosed with DM at <65 years had substantial increased relative risk of: cardiac 1.3, stroke 1.5, mild disability 1.5, severe disability 1.7, death 1.5, (p<0.001 for each). Respondents diagnosed at older ages had moderate increases with similar duration. (Table)

Age of DM diagnosis differentially impacts key outcome risks in older adults and has more impact than duration. Findings reinforce clinical heterogeneity in DM and the focus to improve DM management in middle aged adults.


J. Zhong: None. J. Ha: None. C. Blaum: None. M. Kabeto: None. C. Cigolle: None.

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