Conclusion

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Diabetes is an important contributor to mortality and reduces life expectancy in elderly patients. The most frequent cause of death is cardiovascular disease. The risk profile of mortality changes with advancing age in patients with diabetes, as in the general population. Some risk factors express their powerful deleterious effect at an earlier age (Figure 8.10), when the RR of mortality is the greatest (Figure 8.3). During this lifespan the RR of mortality in patients with Type 2 diabetes peaks and some risk factors express their maximal effect (Figure 8.10). These include gender, obesity and mode of treatment. In patients aged 75 years and older, some of these predictors partially lose significance. Among the parameters of long-term glucose control, mean fasting glucose is a predictor of mortality only when in the multivariate analysis the variability (i.e coefficient of variation) is not included in the model. When the long-term glucose instability is considered, in Type 2 diabetic patients the coefficient of variation of FPG becomes the strongest predictor of mortality, especially in patients older than 75 years. The patients with the highest variability also experience the greatest rate of hypoglycaemic events, and this exposes the patients to an adjunctive risk of cardiovascular mortality.

Sex (women vs men) Age (years)

Diabetes duration (years) BMI (IV vs I quartile) Attending the diabetes clinic Insulin treatment (yes vs no) Smoking (yes vs no) Hypertension (yes vs no) M-FPG (III vs I tertile) S-FPG

CV-FPG (III vs I tertile)

56-74 years

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