A group of researchers led by Dr Toru Aizawa of Shinshu University School of Medicine in Matsumoto, Japan, assessed mortality rates in elderly patients with type 2 diabetes under strict glycaemic and blood pressure control. A total of 388 patients older than 65 years were treated to target levels of HbA1c 7.0%, blood pressure 145/80mmHg, and total cholesterol <240mg/dL for 6 years. Mean baseline HbA1c, blood pressure, and total cholesterol were 6.8%, 137/74mmHg, and 196mg/dL, respectively. After 6 years, these values were 6.9%, 134/72mmHg, and 188mg/dL, respectively.

The researchers found that the mortality rate was 19.6%, which represented a 1.01-fold increase compared with the age- and sex-matched general population. Macroangiopathic events developed in 36.6% of patients, and the incidence of end-stage renal disease was 2.3%. Low glomerular filtration rate, prior stroke, age, and change in body-mass index were independent predictors of mortality, whereas non-smoking was an independent protective factor.

The researchers concluded that mortality among elderly patients with type 2 diabetes under strict glycaemic and blood pressure control was similar to that in the general population. Prominent risk factors for mortality were renal dysfunction, prior stroke, high LDL cholesterol, and prior obesity.

Diabetes Research and Clinical Practice 2007;78:108-14