Newly diagnosed type 2 diabetes patients are older and more comorbid

Researchers used electronic health records from Clalit Health Services in Israel to compare adults with incident type 2 diabetes in 2005–2008 (n=80,201) and 2020–2023 (n=101,392). The retrospective cohort study assessed characteristics at diagnosis and glucose-lowering treatment dispensed 31–90 days afterward. Between-period differences were primarily descriptive; an age-stratified sensitivity analysis was also conducted.

Median age at diagnosis rose from 63.0 to 66.7 years, and the proportion aged 85 years or older increased from 3.5% to 6.6%. The median Charlson comorbidity index increased from 4 to 6. At diagnosis, median HbA1c was lower in the later period (7.0% vs 7.3%), as was pre-diagnosis LDL cholesterol (2.21 vs 2.90 mmol/l). Recorded MASLD prevalence rose from 4.4% to 18.6%. Early SGLT2 inhibitor use increased from 0.07% to 15.0%, and GLP-1 receptor agonist use from 0% to 11.1%; sulfonylurea use fell from 20.8% to 4.5%.

The findings describe changes within one Israeli healthcare system and do not establish their causes. The authors note that increased MASLD recognition may partly explain its higher recorded prevalence. The older, more comorbid profile highlights the need for evidence relevant to very elderly patients, but these descriptive comparisons do not test treatment effectiveness or support specific prescribing changes.