The investigation of blood glucose control and complications in type 2 diabetic patients aged 80 years and over / 中华老年医学杂志

ABSTRACT

Objective To investigate the blood glucose control level,the characteristics of complications and treatment programme in senile patients with type 2 diabetes.Methods From Aug 2010 to Jul 2011,gender,age,height,weight,disease course and underlying disease were recorded in 119 patients with type 2 diabetes aged 80 years and over.The levels of glycosylated hemoglobin (HbA1c),fasting C-peptide (FC-P) and 2 hours postprandial C-peptide (2h C-P),urinary albumin excretion rate (UAER) were tested.Ultrasonic Doppler examination of lower-limb arteries as well as non-mydriatic colour eye-ground photography were also examined,peripheral nerve lesions were evaluatcd according to the criteria of diabetic neuropathy system (DNS).The patients were divided into two groupsHbA1c＜7.0％ group (65 cases) and HbA1c ≥ 7.0 ％ group(54 cases).Results The disease course[(12.1±8.5)years vs.(16.6±7.5)yeas,t=3.01,P=0.003],UAER[(20.2±11.9)μg/min vs.(47.0±21.4)μg/min,t=2.48,P=0.015] and incidence of diabetic nephropathy [23.1％(15/65)vs.50.0％(27/54),x2=9.36,P=0.002] were all less in HbA1c＜7.0％ group than in HbA1c ≥ 7.0％ group,while the levels of FC-P and 2hC P were higher in HbA1c＜7.0％than in HbA1c ≥ 7.0％ group[(2.1±1.2)μg/L vs.(1.5±1.0)μg/L,t=1.87,P=0.042; (6.5± 3.3)μg/L vs.(4.3 ± 2.9) μg /L,t =2.10,P =0.037].The proportion of patients who took oral hypoglycemic agents was increased while those who received insulin therapy decreased in HbA1c＜7.0％ group (all P=0.000).The α-glucosidase inhibitors were the most commonly used in each group,followed by metformin and insulin secretagogue,and the thiazolidinediones were rarely used,while there was no significant difference in the proportion of medicine between the groups.The overall incidence of symptomatic hypoglycemia was 23.5％(28/119).It was higher in HbA1c ≥ 7％ group than in HbA1c＜7.0％ group[33.3％(18/54)vs.15.4％(10/65),x2 =5.20,P=0.022].However,71.4％(5/7)of the patients with hypoglycemic coma came from HbA1c＜7.0％ group.Conclusions There are obvious individual differences in blood glucose control and complications among senile type 2 diabetes patients,thus the characteristics of the elderly should be considered in the choice of drugs while hypoglycemic events should be paid more attention.