The impact of diabetes mellitus on the health of the Taiwanese elder population

[[abstract]]Background and Aims: According to the National Health Insurance (NHI) claim data, the prevalence rate of DM in Taiwan read 3.8% in 2002 and is increasing at an average rate of 0.2% every year. The health care expenditure spent on diabetes patients accounts for approximately 11.5% of the total NHI cost. In this study, we aim to examine the relationships between diabetes and other health outcomes of Taiwanese old people. Materials and Methods: A national-representative, multistage stratified systematic sample of 2353 individuals aged 65 and over from the 2005National Health Interview Survey in Taiwan is analyzed. Among them, 401 cases (17%) are diabetic. Mean ± SD of age for non-diabetic and diabetic subjects are 739±6.5 and 740±6.5 respectively. The analyzed health outcomes include stroke, TIA, kidney diseases, uremia, joints replacement, fall experience, fracture experience, urine incontinence, feces incontinence, use of audiphone, glaucoma, ablepsia, teeth function, daily functional status, use of emergency room, hospitalization, use of dental services, body mass index, depressive symptoms, cigarette smoking, betel quid chewing, physical laboring, and exercise. Chi-square test and logistic regression were applied to examine their correlations. Results: The analyses of chi-square tests show that diabetes patients report a significantly higher rate in terms of stroke, TIA, kidney diseases, joints replacement, fall experience, urine incontinence, stool incontinence, daily functional disability, obesity, depressive symptoms, emergency room and hospitalization utilization, and an obviously lower rate in terms of physical laboring work and dental services utilization. When sex and the other aforementioned significant variables are controlled, the result shows that DM patients have higher odds of TIA (Odds ratio=1.60, 95% CI 1.07–2.40), kidney diseases (Odds ratio=1.62, 95% CI 1.08–2.42) and lower odds of engaging in physical laboring work (Odds ratio=0.66, 95% CI 0.47–0.95). Conclusion: Findings show that DM does have negative impacts on old patients’ health and lifestyle. It is very important to enhance self-management in diabetes patients so as to prevent from advanced health decline