medwireNews: Older adults with a longer duration of type 1 diabetes have an increased likelihood of experiencing depression and hypoglycemia unawareness, researchers report.
“This observation is important for understanding how to manage older adults with [type 1 diabetes] with different disease duration,” say Medha Munshi and colleagues from the Joslin Diabetes Center in Boston, Massachusetts, USA, in Diabetes Care.
They analyzed data from 165 individuals aged at least 65 years (mean 70 years) with type 1 diabetes, 53 of whom had a diabetes duration of at least 50 years while 112 had a shorter diabetes duration. A total of 40% of people in the longer duration group had depression, compared with 26% in the shorter duration group, while 63% and 38%, respectively, had impaired awareness of hypoglycemia.
In a multivariant analysis adjusting for age, sex, and glycated hemoglobin, people in the longer diabetes duration group had over twice the risk for depression and impaired awareness of hypoglycemia than people with shorter diabetes duration, with odds ratios (ORs) of 2.8 and 2.6, respectively.
The team says that these results suggest the need for people with type 1 diabetes to be screened for depression and assessed for hypoglycemia unawareness as they grow older.
Longer diabetes duration was also associated with decreased physical function, as indicated by lower average scores on the 6-minute walk test (401 vs 440 m) and the SF-36 Physical Component Summary (48 vs 51 points), and with a higher average number of medications taken each day (11 vs nine).
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