A Population‐based Study of the Incidence of Complications Associated with Type 2 Diabetes in the Elderly

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Abstract
One hundred and eighty-eight known Type 2 diabetic patients aged over 60 years identified by a geographically based survey of a population of 40 076 were followed for a median of 6 years to determine the incidence of various complications. There were 63 deaths and two patients were lost to follow-up. The presence of complications was determined using a structured questionnaire and clinical examination. Incidence rates of ischaemic heart disease, stroke, and peripheral vascular disease (PVD) were 56 (95% CI 41–75), 22 (13–35), and 146 (117–174) 1000-person-years−1 of follow-up, respectively. Rates of stroke and PVD rose significantly with age. Retinopathy occurred at a rate of 60 (42–83) 1000-person-years−1 and cataract at 29 (17–46) 1000-person-years−1 although visual acuity in survivors did not deteriorate overall, probably reflecting the high mortality associated with cataract. The rate of proteinuria (albumin concentration > 300 mg l−1) was 19 (9–34) 1000-person-years−1. Incidence rates were unrelated to sex or duration of diabetes. Diabetes is associated with a continuing incidence of complications into old age. Adequate facilities are required to assess and treat the resulting morbidity in a population with an increasing proportion of elderly people.