Endocrine Abstracts

Introduction: Diabetes mellitus is a disease that is progressing at an alarming rate in the world. In the elderly, the symptoms are often insidious and atypical, which can delay the diagnosis and the establishment of effective treatment. Indeed, management is not always easy because it must take into account multiple parameters. The objective of our study was to study the clinico-biological and etiological profile of diabetes discovered after the age of 65 years.

Methods: We conducted a retrospective observational study at the National Institute of Nutrition and Food Technology in Tunis, over a period from January 2018 to September 2021. Data were collected from patients’ medical observation records. We prepared an information sheet which was used for the statistical analysis of the data.

Results: We collected 35 elderly diabetic patients. The age of the patients varied from 70 to 89 years with an average age of 76.2 ± 4.5 years. Our population was characterized by a female predominance (66%). Hyper-LDLemia type dyslipidemia was present in 69% of cases with an average duration of evolution of 3.35 ± 2.56 years. Hypertension was present in 40% of the study population. Diabetes was discovered incidentally in 49% of cases. The average duration of diabetes in our population was 5.89 ± 3.91 years with extremes ranging from 1 to 14 years. The average age of discovery was 70.29 ± 4.44 years with extremes ranging from 65 to 79 years. All of our patients were type 2 diabetics. Fasting blood sugar was on average 10.47 ± 4.32 mmol/l with extremes ranging from 6.1 to 29.4 mmol/l. The glycated hemoglobin varied between 6.5% and 13.9% with an average of 8.9 ± 1.9%. More than half of the population had an HbA1c greater than 8.5%. Diabetic retinopathy was present in 40% of patients. Peripheral neuropathy was present in 27% of patients with an average DN4 score of 4.3 ± 1.3. Autonomic neuropathy was mainly manifested by gastroparesis (29%) and orthostatic hypotension (11%). Macroangiopathic complications were dominated by coronary insufficiency (11%) and history of stroke (9%).

Conclusion: These results should encourage the medical community to strengthen screening for diabetes in the elderly and to systematically search for cardiovascular risk factors and, in particular, geriatric syndromes which are often overlooked.