Diabetes in an older Australian population

Purpose: To describe the prevalence of self-reported diabetes and undiagnosed diabetes using new fasting plasma glucose (FPG) criteria, and vascular associations with diabetes history in a representative sample of older Australians attending the population-based Blue Mountains Eye Study. Methods: 3654 people aged 49 years or older, representing 88% of permanent residents in two postcode areas west of Sydney, underwent a detailed medical and eye examination. This included history of diabetes, vascular events and vascular risk factors. Fasting pathology tests, including glucose, were obtained for 88% of these subjects. Results: A diabetes history was given by 217 people (5.9%), including 7.0% of men and 5.2% of women. Elevated FPG (≥ 7.0 mmol/l) was found in a further 66 people (2.2% of persons who had FPG performed) and Impaired Fasting Glucose (FPG ≥ 6.1 mmol/l and < 7.0 mmol/l) was found in a further 127 people (4.2%). History of diabetes was associated with an increased prevalence of obesity, elevated mean blood pressure and serum triglycerides, and lower mean serum cholesterol and HDL-cholesterol. Statistically significant associations were found between diabetes history and history of angina, acute myocardial infarction, stroke, gout and thyroid disease, after adjusting for age and sex using logistic regression. The vascular relationships with diabetes were stronger among people who currently smoked. Conclusions: This study has found similar diabetes prevalence to recently published Australian National Health Survey findings. Strong cross- sectional associations between diabetes history and vascular events and increased prevalence of vascular risk factors among older subjects with diabetes emphasise the need to address vascular risk factors in this group.