Mortality in older people with diabetes mellitus

It is universally acknowledged that diabetes mellitus is a common cause of morbidity in the elderly population but it is less well established that the mortality of people with diabetes is greater at any given age. This comprehensive literature review aims to examine the evidence in order to clarify the relationship between diabetes and mortality risk in elderly diabetic patients. Information was obtained by carrying out a MEDLINE search for relevant papers published in 1980 and onwards; a key paper on mortality in noninsulin-dependent (Type 2) diabetes mellitus (NIDDM) was used as an index paper; Diabetes, Diabetologia, Diabetic Medicine, Diabete et Metabolisme, and Diabetes Care were hand searched; and, finally, other experts in the field were contacted. Two reviewers independently extracted the data from each of the studies and disagreements were discussed and resolved. The studies in elderly study populations comprised mainly NIDDM. The review demonstrated that diabetes is a significant contributor to mortality and reduced life expectancy in elderly subjects. Demographic trends in our population indicate that diabetes will continue to be a challenging health problem. (C) 1997 by John Wiley & Sons, Ltd.