Characteristics of above 65-year-olds with type 1 diabetes in the Finnish diabetic nephropathy study

Acta Diabetol. 2025 Nov 18. doi: 10.1007/s00592-025-02613-0. Online ahead of print.

Abstract

Aims: Ageing in people with type 1 diabetes is identified as a research gap. Therefore, the aim of our study is to characterize above 65-year-olds with type 1 diabetes, and to identify potential protective factors or factors related to increased risk of mortality in this age group.

Methods: This observational study includes 864 participants aged 55 years or older with type 1 diabetes (age at onset below 40) from the Finnish Diabetic Nephropathy Study, grouped according to age into three categories: 55-60, 60-65, and > 65 years old. Multivariable logistic regression analysis was used to identify factors independently associated with age above 65. Cox regression analysis was conducted to assess how these factors impact survival.

Results: Factors that were independently associated with age above 65 years included: higher diabetes onset age, higher pulse pressure, lower mean arterial pressure, absence of current smoking and diabetic kidney disease, history of severe diabetic retinopathy and cardiovascular events, lower daily insulin dose, lower HbA1c, and lowerApoB-100 concentrations. Of these factors, the ones associated with mortality in above 65-year-olds during follow-up were presence of diabetic kidney disease, higher HbA1c, and history of cardiovascular events.

Conclusion: Above 65-year-olds were characterized by both factors generally related to positive and negative health outcomes. Additionally, different factors were found to be associated with reaching older age and with survival beyond the age of 65.

Keywords: Ageing; Cardiometabolic risk factors; Diabetes complications; Diabetes mellitus, type 1.