Endocrine Abstracts

Aim: Diagnosing type 1 diabetes(T1DM) in older adults is often challenging due to atypical presentation and co-morbidities. This study aims to compare glycaemic control, microvascular complications, and diabetic emergencies between younger (<50) and older (≥50) adults in the first few years following diagnosis to better understand the challenges in older populations.

Method: Retrospective-cohort study was conducted on individuals diagnosed with T1DM between 2018 and 2024. Data were collected from SCI Diabetes and Clinical Portal at diagnosis, first and second year, and the most recent follow-up. Information gathered included demographics, HbA1c levels, use of blood glucose monitoring technology, biochemical parameters, and complication rates.

Results: Study included 219 patients: 148 under 50 years (mean -31) and 71 aged 50+ (mean-59). In the younger cohort, the mean HbA1c at diagnosis was 115 mmol/mol, dropping to 69 mmol/mol at follow-up. In the older cohort, it decreased from 114 to 66 mmol/mol. Continuous glucose monitoring (CGM) use was higher in younger groups (92.57%) than older group (86%), while insulin pump usage was similar between two (11.49% in the younger vs. 9.86% in the older). Retinopathy (17%) and diabetic ketoacidosis (29%) were more common in the younger cohort, whereas foot disease (9%) and severe hypoglycaemia (4%) were more frequent in the older. In the younger cohort 0.68% deceased and 2.03% moved out of area whereas 4.22% died in the older cohort. DKA at diagnosis was notably higher during the 2020-COVID year.

Conclusion: Older adults with T1DM face unique challenges, such as higher rates of foot disease and hypoglycemia, while younger adults are more prone to retinopathy and diabetic ketoacidosis. Early integration of technologies like CGM and insulin-pumps, when used effectively, can enhance diabetes care. Personalized, age-specific care strategies are essential for addressing unique needs of each age group and achieving optimal outcomes.