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# Type 2 diabetes being diagnosed at older ages in Israel, and with more co-morbidities
- URL: https://www.coios.me/type-2-diabetes-being-diagnosed-at-older-ages-in-israel-and/
- Published: 2026-10-17T09:14:15.000Z
- Updated: 2026-10-18T12:16:00.000Z
- Description: Median age at diagnosis rose from 63.0 to 66.7 years between 2005-2008 and 2020-2023 in one Israeli health system.
- Author: Daniel Ryan
- Tags: Health today, Heart and stroke, Obesity, diabetes and GLP-1, Israel, #peer-reviewed, #refines, #item, #source-2026-10, #score-75

This retrospective cohort study used Clalit Health Services records from Haifa and Western Galilee, Israel. Adults diagnosed with type 2 diabetes in 2005-2008 (n=80,201) were compared with those diagnosed in 2020-2023 (n=101,392). Median age at diagnosis rose from 63.0 to 66.7 years and Charlson comorbidity score from 4 to 6\. HbA1c fell from 56 to 53 mmol/mol and pre-diagnosis LDL-cholesterol from 2.90 to 2.21 mmol/l. Within 31-90 days of diagnosis, SGLT2 inhibitor use rose from 0.07% to 15.0% and GLP-1 agonist use to 11.1%. Sulfonylurea use fell from 20.8% to 4.5%; recorded steatotic liver disease rose from 4.4% to 18.6%, largely ascertainment-driven.

*Why it is interesting: Diabetes is now detected at older ages with better glycaemic and lipid profiles, altering the baseline risk of incident cohorts. Prescribing has shifted rapidly from sulfonylureas to cardiorenal and weight-acting agents.*

Source

[Diabetologia, 16 October 2026](https://doi.org/10.1007/s00125-026-06901-4?ref=coios.me)

Paper

Evolving phenotype of newly diagnosed type 2 diabetes: a 15-year population-based comparison

Authors

Kirshner D, Hauzer M

DOI

10.1007/s00125-026-06901-4

Type

Peer-reviewed article

Design

Retrospective cohort comparison of two periods in one Israeli integrated health system: incident type 2 diabetes 2005-2008 (n=80,201) vs 2020-2023 (n=101,392)

Verdict

Refines prior evidence

Driver

[Heart and stroke](https://www.coios.me/d-cardiovascular/)

Driver

[Obesity, diabetes and GLP-1](https://www.coios.me/d-obesity-diabetes/)

Free full text

[Free to read at the publisher](https://doi.org/10.1007/s00125-026-06901-4?ref=coios.me)

Abstract — the authors' own words, CC BY

Abstract

Aims/hypothesis

Our aim was to describe the phenotype at diagnosis and the early therapeutic profile of newly diagnosed type 2 diabetes across two periods spanning approximately 15 years within the same integrated healthcare system.

Methods

This retrospective cohort study used electronic health record data from Clalit Health Services (Haifa & Western Galilee, Israel). Adults with incident type 2 diabetes in 2005–2008 (period 1:

n

\=80,201) were compared with those diagnosed in 2020–2023 (period 2:

n

\=101,392). Between-period differences are presented as crude estimates, with an age-stratified sensitivity analysis, and quantified using standardised mean differences (SMDs; values ≥0.20 indicate at least a small effect) alongside non-parametric and χ

2

tests.

Results

The median age at diagnosis increased from 63.0 to 66.7 years between the two periods; the proportion aged ≥85 years nearly doubled (from 3.5% to 6.6%). The score for the Charlson comorbidity index increased from 4 to 6 (SMD 0.48); metabolic dysfunction-associated steatotic liver disease (MASLD) increased from 4.4% to 18.6%. HbA

1c

at diagnosis decreased from 56 to 53 mmol/mol (7.3% to 7.0%); pre-diagnosis LDL-cholesterol decreased from 2.90 to 2.21 mmol/l (SMD 0.65). Within 31–90 days of diagnosis, use of sodium–glucose cotransporter 2 (SGLT2) inhibitors increased from 0.07% to 15.0%, use of glucagon-like peptide-1 receptor agonists (GLP-1RAs) increased from 0% to 11.1%, and sulfonylurea use decreased more than fourfold (20.8% to 4.5%).

Conclusions/interpretation

The phenotype of newly diagnosed type 2 diabetes has been fundamentally restructured since 2008: patients are older with a higher comorbidity burden but present with better glycaemic and lipid management, with the latter reflecting statin therapy already established before diagnosis. MASLD has emerged as a major but largely ascertainment-driven comorbidity. The shift to SGLT2 inhibitors and GLP-1RAs alongside declining sulfonylurea use indicates displacement of glucose-centric strategies by a cardiorenal- and weight-driven paradigm. These findings indicate a need for age-appropriate management and trials enrolling very elderly patients.