That diabetes, which is on the rise in the elderly, can affect functional abilities is no surprise, but there is controversy over whether such decline is caused by diabetes itself or by chronic illnesses that are more common among diabetics.

In the present study, diseases that commonly affect people with diabetes, such as coronary artery disease, did explain some but not all of the difficulties.

Dr. Nathalie de Rekeneire of the National Institute on Aging in Bethesda, Maryland, the study's lead author said that "Several diseases that could be causes of disability are more frequent among diabetic participants."

She also noted that several conditions that can be treated or prevented, including obesity, arthritis, artery disease and depression were associated with early signs of functional decline in people with diabetes.

But de Rekeneire noted that poor control of blood sugar may be to blame for the development of many diabetic complications that can affect functional abilities.

Some steps that can be taken to stave off diabetes-related limitations, according to de Rekeneire, include decreasing obesity by making diet and exercise changes and early diagnosis and treatment of diabetes complications. Intensive control of blood sugar may also help, she noted, since studies have shown that proper blood sugar control can prevent or slow the progression of several diabetes-related complications.

The study included almost 3,000 people in their 70s. Participants were not disabled and 19 percent had diabetes.

Although the participants were not disabled, about 43 percent had some trouble with their daily activities, including getting out of a chair and climbing stairs. Such difficulties were more common in people with diabetes than people who did not have the disease: 53 percent versus 40 percent, respectively.

The relationship between diabetes and functional difficulties remained strong after researchers accounted for differences in age, sex and race. It diminished somewhat once weight, diabetes complications and other illnesses were factored in, but people with diabetes were still more likely to have these limitations.

Source: Diabetes In Control.com: Diabetes Care, December 2003.

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