文章基本信息

标题：Aging, Diabetes, and the Public Health System in the United States
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作者：Carl J. Caspersen ; G. Darlene Thomas ; Letia A. Boseman 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2012
卷号：102
期号：8
页码：1482-1497
DOI：10.2105/AJPH.2011.300616
语种：English
出版社：American Public Health Association
摘要：Diabetes (diagnosed or undiagnosed) affects 10.9 million US adults aged 65 years and older. Almost 8 in 10 have some form of dysglycemia, according to tests for fasting glucose or hemoglobin A1c. Among this age group, diagnosed diabetes is projected to reach 26.7 million by 2050, or 55% of all diabetes cases. In 2007, older adults accounted for $64.8 billion (56%) of direct diabetes medical costs, $41.1 billion for institutional care alone. Complications, comorbid conditions, and geriatric syndromes affect diabetes care, and medical guidelines for treating older adults with diabetes are limited. Broad public health programs help, but effective, targeted interventions and expanded surveillance and research and better policies are needed to address the rapidly growing diabetes burden among older adults. Diabetes mellitus is “a group of diseases marked by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.” 1 ^(p11) Diabetes has 2 primary forms: type 1, previously called insulin-dependent or juvenile-onset diabetes, and type 2, previously called non–insulin-dependent or adult-onset diabetes; the latter accounts for about 90% to 95% of all diagnosed cases of diabetes. In 2005 to 2008, 25.8 million Americans, or 8.3% of the US population, had diabetes, and an additional 79 million had prediabetes, according to fasting glucose or hemoglobin A1c tests. 1 As the average age of the US population rises, the prevalence of diabetes among adults is projected to increase to 14% to 33% by 2050. 2 Because the anatomical and physiological changes characteristic of the normal aging process are accelerated in people with diabetes, 3,4 life expectancy is shorter. For example, among people aged 55 to 64 years, diabetes reduces life expectancy by 8 years. 5,6 A 57-year-old person with diabetes may have a biological age equivalent to that of a person aged 65 years without diabetes. Along with the importance of chronological and biological age, certain ages have social (typical retirement age), political, 7 or programmatic significance, 8 which should be considered in planning strategies for addressing diabetes among older adults. Older adults with diabetes present special epidemiological and public health challenges, and public health actions to prevent and control diabetes in this growing subpopulation should address these.