Comprehensive approaches to diabetes in the elderly: adapting to evolving trends

Abstract

Background/Aims: The prevalence of diabetes mellitus (DM) is increasing worldwide owing to aging. This nationwide study aimed to investigate the prevalence of DM and its management status among elderly Koreans. Methods: We analyzed data from the Korea National Health and Nutrition Examination Survey (2019–2021) to assess the prevalence of DM, awareness, treatment rates, and glycemic control status among elderly Koreans aged ≥ 65 years. Results: The prevalence of DM increased significantly from 2019 to 2021, reaching 30.9% among elderly Koreans by 2021. Women were older than men (73.7 ± 5.0 vs. 72.7 ± 4.9 years, p < 0.001) and had higher BMI than men (24.5 ± 3.0 vs. 25.1 ± 3.6 kg/m2, p < 0.001). The waist circumference was 91.5 ± 8.8 cm in men and 88.8 ± 9.2 cm in women (p < 0.005). The prevalence of obesity among patients with DM was 44.5%, significantly higher in women (47.4%) than men (41.2%; p = 0.003). Women also had higher rates of hypertension and hypercholesterolemia than men (hypertension: 74.0% vs. 66.5%, p < 0.005; hypercholesterolemia: 53.0% vs. 38.5%, p < 0.001). Women exhibited higher awareness rates of DM compared to men. Awareness and treatment rates were higher in older individuals compared to those aged 30–64 years. Regarding glycemic control, the target achievement rate was 61.0% for HbA1c < 7.0% in the total age group, with nearly 27.6% achieving strict control (HbA1c < 6.5%). Conclusions: Our study underscores the rising DM prevalence among elderly Koreans and emphasizes the need for age-tailored management approaches to optimize care.