Clinical characteristics of Chinese patients with duration of type 2 diabetes >40 years

J Diabetes. 2017 Jan;9(1):45-52. doi: 10.1111/1753-0407.12375. Epub 2016 Mar 9.

Abstract

Background: Although type 2 diabetes mellitus (T2DM) shortens life expectancy by 10-12 years, some patients survive extremely long durations of diabetes. The clinical characteristics of Chinese patients with >40 years T2DM remain unknown. Thus, the aim of the present study was to document the clinical profile of patients with T2DM for ≥40 years.

Methods: The present study evaluated 157 survivors with >40 years T2DM from a total of 582 773 patients with T2DM enrolled in a Chinese national survey of HbA1c. Two matched case-control studies were performed on long T2DM survivors (cases) separately matched according to: (1) survey day, sex, and survey hospital; and (2) age, sex, and survey hospital. Conditional logistic regression analysis was performed to obtain odds ratios (ORs) for long survival.

Results: Patients with a long duration of T2DM had a mean (± SD) age of 75 ± 10 years. Their T2DM had been diagnosed at a mean age of 32 years and the median duration of diabetes was 41 years. In both case-control studies, long-duration T2DM was associated with an increased risk of hyperglycemia (OR 6.31; 95% confidence interval [CI] 1.89-21.09) and coronary heart disease (CHD; OR 2.18 95% CI 1.01-4.70). However, long-duration T2DM was not associated with a higher likelihood of abnormal lipids, diabetic nephropathy (DN), or stroke compared with patients with a shorter duration of T2DM.

Conclusions: The present study suggests that Chinese patients with long-term T2DM also had increased risks of hyperglycemia and non-fatal CHD. Further studies are needed to investigate whether survival of these patients was associated with non-increased risk of DN.

Keywords: Chinese; diabetic nephropathy; long-term diabetes; long-term survivors; type 2 diabetes mellitus.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Glucose / metabolism
  • Case-Control Studies
  • China
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / pathology*
  • Female
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Male

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • hemoglobin A1c protein, human