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Int J Clin Pract. 2015 Dec;69(12):1486-95. doi: 10.1111/ijcp.12741. Epub 2015 Sep 30.

Older type 2 diabetic patients are more likely to achieve glycaemic and cardiovascular risk factors targets than younger patients: analysis of a primary care database.

Author information

1
Primary Health Care Center Doctor Jordi Nadal, Gerència d'Àmbit d'Atenció Primària Girona Ciutat, Institut Catala de la Salut, Salt, Spain.
2
DAP-Cat group, Unitat de Suport a la Recerca Barcelona ciutat, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.
3
Primary Health Care Center La Mina, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Sant Adrià de Besòs, Barcelona, Spain.
4
CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain.
5
Primary Health Care Center Raval Sud, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Barcelona, Spain.
6
Primary Health Care Center El Carmel, Gerència d'Àmbit d'Atenció Primària Barcelona Ciutat, Institut Català de la Salut, Barcelona, Spain.
7
Department of Endocrinology & Nutrition, Health Sciences Research Institute & Hospital Universitari Josep Trueta, Girona, Spain.
8
CIBER on Patophisiology, Obesity and Nutrition (CIBERON), Instituto de Salud Carlos III (ISCIII), Girona, Spain.
9
Department of Endocrinology & Nutrition, Health Sciences Research Institute & Hospital Universitari Germans Trias i Pujol, Badalona, Spain.

Abstract

BACKGROUND:

Older subjects with type 2 diabetes mellitus (T2DM) have differential characteristics compared with middle-aged or younger populations, and require tailored management of the disease.

AIMS:

To evaluate how clinical characteristics, degree of control of glycaemia and cardiovascular risk factors, presence of chronic complications and treatments differ between older T2DM patients and younger adults.

METHODS:

Cross-sectional study using data from a population-based electronic database. We retrieved data from 318,020 patients ≥ 30 years diagnosed with T2DM, attended during 2011 in primary care centres in Catalonia, Spain. We performed descriptive and comparative analyses stratified by gender and age subgroups: ≤ 65, 66-75, 76-85 and >85 years.

RESULTS:

Both men and women across older age subgroups (> 65 years) had longer diabetes duration than younger adults (8.0 vs. 5.6 in men and 8.4 vs. 6.9 years in women; p < 0.001), but better glycaemic control (mean glycated haemoglobin 7.1 vs. 7.7 in men and 7.1 vs. 7.4 in women; p < 0.001), and better combined control of different cardiovascular risk factors (p < 0.001). Moreover, older patients were more likely to achieve glycaemic targets irrespective of having cardiovascular disease. The use of oral antidiabetics decreased with increasing age, and insulin in monotherapy was more frequently prescribed among patients in the older age subgroups. Diabetes-related complications were more frequent in men of all group ages. In the older age subgroups, patients of both sexes had a longer duration of T2DM but better glycaemic control. In this context, the prevalence of diabetic retinopathy decreased unexpectedly with increasing age.

CONCLUSION:

Control of glycaemia and cardiovascular risk factors was better among older T2DM patients. There is a need for prospective studies to quantify the weight of risk factors in each complication to adapt the therapeutic and care approaches in elderly people.

PMID:
26422335
PMCID:
PMC5054846
DOI:
10.1111/ijcp.12741
[Indexed for MEDLINE]
Free PMC Article

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