Visual Abstract

Background: A growing number of older adults with type 1 diabetes (T1D) live into old age, yet, little is known about the burden of and sex differences in diabetes-related complications in this unique group.

Methods: We examined the prevalence of diabetes-related complications in 780 adults aged ≥60 with T1D from the Study of Longevity in Diabetes (SOLID) overall and by sex across categories of T1D duration (<20 years, 20-29, 30-39, 40-49, 50+). Complications were self-reported: retinopathy, neuropathy, nephropathy, lifetime severe hypoglycemic event or diabetic ketoacidosis (DKA) resulting in inpatient/ ED utilization. Sex differences were examined using logistic regression models adjusted for diabetes duration, age, and race/ethnicity.

Results: Average (SD) age at baseline and duration of T1D were 67.3 (6.4) and 39.5 (14.9). Among those with T1D ≥50 years (Figure), prevalence of retinopathy, neuropathy and lifetime severe hypoglycemic event were all >60%. Women were more likely to report retinopathy (OR=1.49; 95% CI: 1.09, 2.03) and DKA (OR=1.92; 1.39, 2.66); no other sex differences were observed.

Conclusions: Results quantify the burden of complications across a range of T1D duration and report key sex differences. Findings underscore how widespread diabetes-related complications are in those with longer T1D duration and highlight complications that disproportionately impact women.


M. L. Leigh: None. P. Gilsanz: None. C. Moran: None. A. J. Karter: Research Support; Self; Dexcom, Inc. R. A. Whitmer: None.


National Institute on Aging (R01AG047500); National Center for Advancing Translational Sciences (KL2TR001996)

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at