Inadequate Glycaemic Control and Therapeutic Management of Adults over 65 Years Old with Type 2 Diabetes Mellitus in Spain.

ABSTRACT

OBJECTIVES: The glycaemic goals for older patients with type 2 diabetes mellitus (DM) are recommended to avoid an HbA1c levels <7%. The purpose of this study was to analyse the glycaemic control and therapeutic management of older adults (≥65 years) with type 2 DM. DESIGN: Pooled analysis of patients enrolled in three Spanish cross-sectional epidemiological studies. SETTING: The study was conducted between 2009 and 2011 by primary care or specialist physicians. PARTICIPANTS: A total of 7,269 patients aged ≥65 years with type 2 DM. MEASUREMENTS Sociodemographic, medical history, lifestyle habits, biochemical laboratory parameters, comorbidities, type 2 DM complications, and pharmacological treatment data collected from medical records. RESULTS: In total, data from 7,269 patients were analysed (mean age 73.4 years old; 48.4% male). A total of 10.9% of patients had HbA1c levels ≥8.5% and 43.2% <7%. The most common comorbidities were hypertension (82.0%) and dyslipidaemia (76.6%). The microvascular complications were mainly diabetic nephropathy (23.6%) and retinopathy (19.3%). Oral antidiabetic drugs (OADs) were taken by 70.5% of patients (sulphonylureas 65.3%), 4.1% were taking insulin alone and 25.4% took both insulin and an OAD. Half of the patients (51.0%) were taking a combination of OADs. CONCLUSION: In conclusion, more than half of older patients with type 2 DM had unsatisfactory management approximately one in ten had inadequate glycaemic control (HbA1c ≥8.5%) despite hypoglycaemic drugs and four in ten were potentially overtreated (HbA1c <7%).