Diabetes Type 2 in the Berlin Aging Study II: Prevalence, Incidence and Severity Over up to Ten Years of Follow-up

Aim: To describe the prevalence, incidence, and severity of diabetes mellitus type 2 (T2D) and antidiabetic medication in older people and to assess the prognostic value of diagnostic laboratory parameters.Methods: Baseline data of 1,671 participants of the Berlin Aging Study II (68.8 ±3.7 years) and follow-up data assessed 7.4 ±1.5 years later were analysed. T2D was diagnosed based on self-report, antidiabetic medication use, laboratory parameters. T2D severity was determined by the diabetes complications severity index (DCSI). Prognostic capacity of laboratory parameters was evaluated by Receiver Operating Characteristics (ROC) and Areas Under the Curve (AUCs).Results: The proportion of participants with T2D increased from 12.9% (37.3% women) at baseline to 17.1% (41.1% women) with 74 incident cases and 22.2% not being aware of the disease at follow-up. More than half of the 41 newly identified incident T2D cases were diagnosed solely by the 2h-plasma glucose test (OGTT) and diagnosis based on OGTT as the only criterion among incident cases was found more frequently in women (p=0.028). The OGTT assessed at baseline predicted incident T2D less accurate in men (AUC: 0.671, 95% CI 0.570-0.771) when compared to women (AUC: 0.7893, 95% CI 0.7036-0.8751). No sex differences were detected with respect to antidiabetic medication used and T2D severity. Conclusions: A comprehensive picture of T2D with respect to prevalence, incidence, and severity in older people is provided. Clinically relevant sex differences in the capacity of the commonly used T2D diagnostic laboratory parameters to predict incident T2D on average 7.4 years later were detected.