Endocrine Abstracts

Aim: Diagnosis of type 1 diabetes in older adults can be challenging, and management can be complicated by co-morbid conditions. In this study we aimed to compare glycaemic control, microvascular complications and diabetic emergencies (severe hypoglycaemia and diabetic ketoacidosis) in the early years following diagnosis between younger adults (<50) and older adults (≥50).

Method: A retrospective cohort study was performed on people with newly diagnosed type 1 diabetes between 2012 & 2018. Data was gathered using SCI diabetes and Clinical Portal at: time of diagnosis; 1 year; 2 years and; most recent recorded value. Data included patient demographics, HbA1c, biochemical parameters including autoantibodies and complications.

Results: : 122 patients were included following exclusion (253 patients). 77 were <50 at time of diagnosis (mean 33) and 45 were aged ≥50 (mean 58). 71% patients <50 were male while 64% patients ≥50 were female. 69% patients ≥50 had originally been diagnosed with type 2 diabetes, and 84% had GAD antibodies taken of which 76% positive. Of those aged <50, mean HbA1c was 95 at diagnosis; 60 at 1 year; 64 at 2 years; and most recent 68: while in 50 or over cohort, mean HbA1c at diagnosis was 108; 62 at 1 year; 66 at 2 years; and most recent 67. Both foot disease and CKD were more common (9% and 9%) in >50 group compared to <50 group (1% & 0%), but numbers not seen to progress during study period. More older adults had hypoglycaemia (7% in >50, 4% in <50), but younger adults had more DKA (11% in >50, 16% in <50).

Conclusion: : Complications were more common in newly diagnosed older adults with type 1diabetes despite having a similar glycaemic control during the study period. It emphasises the importance of individualisation of therapy in the care plan of older patients.