4.6 Article

Diabetes Mellitus in Centenarians

Journal

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 60, Issue 3, Pages 468-473

Publisher

WILEY
DOI: 10.1111/j.1532-5415.2011.03836.x

Keywords

centenarians; type 2 diabetes mellitus; glycosylated hemoglobin

Funding

  1. National Institute on Aging [P01AG17553]
  2. Duke Behavioral Medicine Research Center
  3. [PENR-2008-05011]
  4. [PENR-2010-04643]
  5. [R21CA158877]
  6. [R01AG13180]
  7. [R01HL081290]
  8. [P01HL036587]

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OBJECTIVES: To describe the prevalence of diabetes mellitus (DM) in centenarians. DESIGN: Cross-sectional, population-based. SETTING: Forty-four counties in northern Georgia. PARTICIPANTS: Two hundred forty-four centenarians (aged 98-108, 15.8% male, 20.5% African American, 38.0% community dwelling) from the Georgia Centenarian Study (2001-2009). MEASUREMENTS: Nonfasting blood samples assessed glycosylated hemoglobin (HbAic) and relevant clinical parameters. Demographic, diagnosis, and DM complication covariates were assessed. RESULTS: 12.5% of centenarians were known to have DM. DM was more prevalent in African Americans (27.7%) than whites (8.6%, P <.001). There were no differences between men (16.7%) and women (11.7%, P =.41) or between centenarians living in the community (10.2%) and in facilities (13.9%, P =.54). DM was more prevalent in overweight and obese (23.1%) than nonoverweight (7.1%, P =.002) centenarians. Anemia (78.6% vs 48.3%, P =.004) and hypertension (79.3% vs 58.6%, P =.04) were more prevalent in centenarians with DM than in those without, and centenarians with DM took more nonhypoglycemic medications (8.6 vs 7.0, P =.02). No centenarians with HbAlc of less than 6.5% had random serum glucose levels greater than 200 mg/dL. DM was not associated with 12-month all-cause mortality, visual impairment, amputations, cardiovascular disease, or neuropathy. Thirty-seven percent of centenarians reported onset before age 80 (survivors), 47% between age 80 and 97 (delayers), and 15% aged 98 and older (escapers). CONCLUSION: Diabetes mellitus is a risk factor for cardiovascular disease and mortality but is seen in persons who live into very old age. Aside from higher rates of anemia and use of more medications, few clinical correlates of DM were observed in centenarians. J Am Geriatr Soc 60:468-473, 2012.

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