Disparities in Older Patients With Diabetes

Disparities in Older Patients With Diabetes

Studies show that the prevalence of type 2 diabetes among adults aged 65 and older in the United States ranges between 20% and 25%. However, controversy has surrounded the most appropriate approaches to treating and managing diabetes in older adults, particularly with regard to identifying therapeutic targets for A1C and the control of other cardiovascular risk factors. In addition, research suggests there are disparities in risk factor control among racial and ethnic minorities with diabetes when compared with whites who have the disease. “Diabetes continues to be a major public health problem among older racial and ethnic minorities,” says Hermes J. Florez, MD, MPH, PhD. There are important factors to consider when managing this older patient group and developing treatment targets. These include the potential for adverse effects when using pharmacologic treatment, risks for hypoglycemia, and individual comorbidities, among other factors.   A Closer Look For a study published in Diabetes Care, investigators assessed data from the Atherosclerosis Risk in Communities (ARIC) study (2011–2013), which involved non-institutionalized, community-dwelling older adults with diabetes. The cross-sectional analysis involved more than 5,000 participants aged 67 to 90 with and without diagnosed diabetes who attended the fifth visit of the ARIC study. The authors evaluated the prevalence of glycemic, lipid, and blood pressure (BP) control overall and by race. The study also investigated correlates of meeting treatment targets and whether or not racial differences in risk factor control could be explained by demographic and clinical characteristics. Stringent risk factor targets were defined as having an A1C of less than 7%, an LDL cholesterol (LDL-C) level of less than 100 mg/dL, and a BP...