Current status of diabetes management in elderly Koreans with diabetes.
Knowledge about the current status of diabetes management is indispensable for the improvement of diabetes management. We performed a survey to investigate the current trend of diabetes management in elderly Koreans, at eight hospitals located throughout the country. A total of 539 patients with type 2 diabetes older than 65 years (men=224, women=315) were recruited. Their mean age was 71.5+/-4.9 years and BMI 24.3+/-3.4 (men=23.6+/-2.8, women=24.9+/-3.7)kg/m(2), and 38.2% of the patients were obese (BMI> or =25 kg/m(2), men=29.5%, women=44.4%). The mean duration of the diabetes was 13.1+/-9.2 years. Although 37.3% of the patients had A1C below 7.0%, 33.8% of the patients had A1C more than 8.0%. Three hundred and sixty three patients (67.4%) were treated with oral hypoglycemic agents and 175 patients (32.5%) were treated with insulin or combination with oral agents. The glycemic control was better in patients treated with oral agents (oral agent group=7.7+/-4.6%, insulin group=8.5+/-1.9%). Although mean SBP and DBP were 131.4+/-16.7 and 75.9+/-10.4 mmHg, respectively, 67.4% of the patients had hypertension and 38.2% of the patients with hypertension did not reach the goal (<130/80 mmHg). Of 539 elderly patients, 253 patients (47.4%) had dyslipidemia (LDL-C> or =4.1 mmol/l and/or triglyceride> or =2.5 mmol/l and/or HDL-C<1.1 mmol/l) and 72.7% of the patients with dyslipidemia took the lipid lowering agents. However, 47.4% of them did not achieve the goal (LDL-C<2.6 mmol/l and/or triglyceride<1.7 mmol/l and/or HDL-C>1.1 mmol/l). Twenty-eight patients (5.5%) had been admitted to the hospital because of severe hypoglycemia. Half of the patients (57%) had microvascular complications (retinopathy, neuropathy or overt proteinuria), and 28% of the patients had macro-vascular complications (CVD, stroke or peripheral vascular disease). As elderly diabetic patients are usually polymorbid, diabetes mellitus in old age is needed a more comprehensive approach to not only the treatment of hyperglycemia but also of hypertension, dyslipidemia and other associated diseases.
Noh
Jung-Hyun
JH
Department of Internal Medicine, Inje University College of Medicine, Koyang, Korea.
Kim
Su-Kyung
SK
Cho
Young-Jung
YJ
Nam
Hong-Uoo
HU
Kim
In-Ju
IJ
Jeong
In-Kyung
IK
Choi
Moon-Gi
MG
Yoo
Hyung-Joon
HJ
Ahn
Yoo-Hun
YH
Bae
Hak-Yun
HY
Jang
Hak C
HC
D000368:Aged; D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000503:physiopathology* / Q000534:rehabilitation; D015444:Exercise; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000145:classification / Q000627:therapeutic use; D007723:Korea; D008297:Male; D010353:Patient Education as Topic
D001786:Blood Glucose; D007004:Hypoglycemic Agents