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Volume 10 Supplement 1

de Senectute: Age and Health Forum

Laboratory markers of diabetes mellitus in the elderly

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Background

Diabetes mellitus is a leading cause of morbidity and mortality in Western countries. To prevent diabetic chronic complications, various trials have validated the need for tight glycemic control [1]. Important laboratory markers used in the follow-up of diabetic patients include glycated hemoglobin (HbA1c) [2, 3] and microalbuminuria [3], an important predictor of diabetic nephropathy.

The aim of this study is to evaluate HbA1c as a significant index of glycemic control, and to determine the prevalence of microalbuminuria in elderly diabetic patients in our geographic area.

Materials and methods

HbA1c levels were measured using a high-pressure liquid chromatography methodology (HA 8160, Menarini Diagnostics), and analysed in 352 consecutive diabetic patients (age: >41 years) within a two month time period (September-October 2009). The optimal HbA1c target for diabetic patients was considered <7%, as recommended by the American Diabetes Association. Urinary albumin levels were measured by an immunoturbidimetric assay (BN II, Dade Behring) in 226 consecutive diabetic patients (age: >41 years) within the same time period. Microalbuminuria was diagnosed if albumin in urine samples was > 30 mg/L.

Results

Within the patients examined, the overall HbA1c mean is 6.95% +1.51, and the overall prevalence of high HbA1c (>7%), indicative of poor glycemic control, is 34.4%. Interestingly, the prevalence of patients with high HbA1c is over 30% in any age range examined, with a peak in the age range 61-70 (Table 1). However, while the overall prevalence of microalbuminuria is 19.2%, in agreement with data reported by the Italian Ministry of Health, microalbuminuria is diagnosed in about 8% of diabetics under 60 years, and in almost 30% of patients over 60 years (Table 2).

Table 1 Table 1
Table 2 Table 2

Conclusions

Our data indicate that a sub-optimal glycemic control is observed in more than 30% of the diabetics examined, regardless of age. Furthermore, our data confirm that older age is associated with an increased risk of microalbuminuria and progressive impairment of renal function.

References

  1. 1.

    UK Prospective Diabetes Study (UKPDS) Group: Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998, 352: 837-853. 10.1016/S0140-6736(98)07019-6.

  2. 2.

    Qaseen A, Vijan S, Snow V, Cross JT, Weiss KB, Owens DK: Glycemic control and type 2 diabetes mellitus: the optimal hemoglobin A1c targets. A guidance statement from the American College of Physicians. Ann Intern Med. 2007, 162 (z): 417-422.

  3. 3.

    American Diabetes Association: Standards of Medical Care in Diabetes—2009. Diabetes Care. 2009, 32 (z): S13-S61. 10.2337/dc09-S013.

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Author information

Correspondence to D Foti.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Foti, D., Greco, M., Falbo, M. et al. Laboratory markers of diabetes mellitus in the elderly. BMC Geriatr 10, A108 (2010) doi:10.1186/1471-2318-10-S1-A108

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Keywords

  • Glycemic Control
  • Diabetic Nephropathy
  • Poor Glycemic Control
  • Glycated Hemoglobin
  • Laboratory Marker