The international literature suggests a complex interplay between the effects of age, age at diagnosis and diabetes duration on different vascular beds, and across different clinical outcomes.
A national, cross-sectional study of data from the 2015 ANDA-AQCA database. Subjects included patients with type 2 diabetes, over 18 years old, presenting to a participating Diabetes Centre, during a 1-month survey period in May or June 2015. Pre-specified demographic and clinical variables were obtained. Logistic regression was used to examine factors (age at survey, age at diagnosis and diabetes duration) associated with complications (macrovascular and microvascular events).
Data from 4271 patients were included. Mean (±SD) age was 62.9±12.5y and age at diagnosis was 49.4±12.3y, with 9%, 30%, 45% and 17% of patients reporting age at diagnosis as <45, 45-59, 60-74 and ≥75y, respectively. Mean (±SD) diabetes duration was 13.5±9.4y, with 18%, 19%, 20% and 43% of patients reporting durations of <5, >5–10, >10–15 and ≥15y, respectively.
Age and age at diagnosis were significantly correlated (co-efficient 0.69 p<0.0001). Age, age at diagnosis, and diabetes duration were all associated with increased risk of macrovascular events (Table 1). In multivariable models including either age and diabetes duration or age at diagnosis and diabetes duration, all associations remained significant after further adjustment for sex, smoking, BMI and microvascular disease (p<0.010)(Table 1). In contrast, age and diabetes duration were associated with increased risk of microvascular events but age at diagnosis was not. In multivariable models including age and diabetes duration, only diabetes duration remained significantly associated after further adjustment for sex, smoking, and macrovascular disease (p<0.003)(Table 1).
Age, age at diagnosis, and diabetes duration were independently associated with macrovascular events whereas only diabetes duration was independently associated with microvascular events. Understanding these relationships may assist in communicating prognosis and targeting preventive measures.