Insulin Therapy Responsible for Higher Mortality in Older Diabetic Patients Than Oral Hypoglycemic Agents

A group of researchers have come to the conclusion that Diabetes mellitus (DM) mortality risk is relatively higher among the older adults and women. Especially the women treated with insulin therapy recorded a significantly higher risk of mortality.

The research was conducted on a sample size of 5,372 women aged 65 years and above without DM. One group includes 322 with DM treated with oral hypoglycemic agents (OHGAs). The other group was with 194 women with DM treated with insulin. Participants were followed for total, cardiovascular disease (CVD), coronary heart disease (CHD), and non-CVD/non cancer mortality.

The end result shows that compared with non-DM participants, those treated with OHGAs or insulin had adjusted hazard ratios (HRs) for total mortality of 1.33 and 2.04 (95% confidence interval [CI], 1.10 to 1.62) and 2.04 (95% CI, 1.62 to 2.57); CVD mortality, 1.99 (95% CI, 1.54 to 2.57) and 2.16 (95% CI, 1.54 to 3.03); CHD mortality, 2.47 (95% CI, 1.89 to 3.24) and 2.75 (95% CI, 1.95 to 3.87); and infectious and renal mortality, 1.35 (95% CI, 0.70 to 2.59) and 6.55 (95% CI, 4.18 to 10.26), respectively.

Epidemiological studies so far, have indicated that diabetes increases the risk of death (mortality) from CVD in young and middle-aged people, but it is not known whether this is also true for old people. This information would help physicians provide health care and lifestyle advice to people with diabetes.

At the bottom line, the findings of the study suggest the negative impact on the mortality rate of diabetes persists into old age and that death from CVD is currently declining in both older diabetic people and non-diabetic people. The study further suggested that diabetic people treated with insulin are at a greater risk of dying relative to people without diabetes and those taking oral hypoglycemic agents. The results of this study also indicate that rectifying this situation could prolong the lives of many elderly people with diabetes.

Source: PLOS MEDICINE
Mortality in Pharmacologically Treated Older Adults with Diabetes: The Cardiovascular Health Study, 1989–2001

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