Abstract
This study aimed to find the prevalence of symptoms of diabetes, its relationship to previously undiagnosed diabetes within an elderly population, and its relationship to indices ofglycaemia within the diabetic subjects.
It was designed as a cross‐sectional survey of the prevalence of previously undiagnosed diabetes, diagnosed by glucose tolerance test(GTT), and the prevalence ofpolyuria or polydipsia ascertained by questionnaire, in Melton Mowbray, Leicestershire, UK. All residents aged 65, 70, 75, 80 and 85 years, and spouses who were alive, willing, and not known to have diabetes, had a glucose tolerance test; 1 in 5 of all subjects and all subjects with possible diabetic GTT were asked if they had polyuria or polydipsia. All subjects with diabetic GTT had indices of glycaemic level measured. Diabetes mellitus was defined by 1985 WHO criteria, and symptoms ofpolyuria and/or polydipsia classified as present or absent. In diabetic subjects glycated haemoglobin level, fructosamine level and glycosuria were recorded.
Of 24 elderly subjects found to have previously undiagnosed diabetes during the Melton diabetes survey, only seven hadpolyuria/polydipsia. Of 210 subjects with normal glucose tolerance, five had symptoms. Of 20 subjects with impaired glucose tolerance, none had symptoms. In the subjects found to be diabetic, symptoms were not related to presence/absence of glycosuria, diuretic use or indices ofglycaemia. Seventeen of the diabetic subjects were aged 78 years or less and these included all seven symptomatic subjects.
Both the British and American Diabetes Associations' public awareness campaigns stress the presence of symptoms of diabetes as reasons to consult a physician. Previous studies have suggested that these symptoms are common in subjects with newly diagnosed diabetes. However, polyuria and polydipsia are uncommon in the elderly with undiagnosed diabetes and are extremely unlikely in octogenarians; otherwise there is no overt reason why individual diabetic subjects may or may not get polyuria/polydipsia. Public awareness campaigns should emphasize that absence of symptoms does not exclude diabetes.