Objective: The purpose of this study is to explore potential prognostic factors and contribute scientific evidence of treatment for the elderly with type 2 diabetes (T2D).
Methods: Japanese patients with T2D aged ≥20, who had received regular medical examination for at least a year and had no history of malignancy for 5 years before enrollment, were consecutively registered. Information on subjects’ physical findings, laboratory data, and outcome was collected each year. In this study statistical analysis was performed in the participants followed for 3 years.
Results: As of October 2017, 205 patients were identified as analytical objects. The patients were divided into two groups; the elderly: ≥65 years (n=111, age 73.6 years, T2D duration 16.4 years, HbA1c 7.1%) and the non-elderly: <65 years (n=94, age 55.6 years, T2D duration 12.3 years, HbA1c 7.1%). At baseline, as compared with the non-elderly, the elderly had significantly low BMI (24.4 vs. 27.1 kg/m2), diastolic blood pressure (74.1 vs. 78.2 mmHg), fasting plasma glucose levels (107.5 vs. 125.0 mg/dL), eGFR (63.7 vs. 75.5 mL/min/1.73 m2), and fasting triglyceride levels (107.5 vs. 125.0 mg/dL). Over 3 years, a significant difference in those above was continuously observed between the two groups, whereas the elderly had significantly lower postprandial triglyceride levels than the non-elderly (130.0 vs. 155.7 mg/dL). In addition, urinary albumin excretion rate significantly increased from a baseline of 220.7 to 400.5 mg/gCr with eGFR decline (56.9 mL/min/1.73 m2) in the elderly, but not in the non-elderly.
Conclusions: Albuminuria is well known to be associated with development of cardiovascular diseases. In Japanese elderly patients with long T2D duration and well-controlled HbA1c, blood pressure, and blood lipid, progressive albuminuria with eGFR decline may have the potential to determine their cardiovascular prognosis.
M. Yamazaki: None. Y. Shibata: None. Y. Kawai: None. M. Komatsu: None.