Study On The Conversion And Therapy Of The Senile Patients At High Risk Of Diabetes

Both patients who suffered from impaired glucose tolerance and metabolic syndrome are at high risk of diabetes. In this study, we discussed the two types of metabolic disorders, wishing to have new thinking about prevention and therapy of diabetes.The study consists of two parts. In part one,248 IGT patients diagnosed in 1996 were followed up for 13 years.97 patients completed the 13-year follow-up till 2009. Of the 97 patients,72 (74.2%) and 9 (9.3%) had their IGT converted to diabetes and NGT, respectively, and 16 (16.5%) had their IGT unchanged. The annual conversion rate of IGT to diabetes mellitus was 5.7%. Logistic multi-regression analysis showed that only 2h plasma glucose of OGTT had an independent effect on the conversion of IGT. It was more likely for IGT to convert to diabetes mellitus when the 2h plasma glucose of OGTT was higher than 9.4mmol/L. The risk of IGT conversion to diabetes mellitus was stable IGT>unstable IGT>NGT. In part two, we compared the therapeutic status and efficacy of metabolic syndrome in two groups of senile patients under different medical care systems. Of the two groups, one consisted of veteran cadres and the other community residents. The veteran cadres had a higher treatment rate of metabolic syndrome than the community residents. The treatment rate of diabetes, hypertension, dyslipidemia and impaired glucose regulation (IGR) in the two groups were 76.2%,85.7%,55.7%,10.1% and 48.8%,74.8%,19.7%,3.4%, respectively. Biguanides, Sulfonylureas and a-glucosidase Inhibitors were the most frequently used drugs for blood sugar control. The most commonly used hypotensors were Calcium Channel Blockers (CCB), Angiotensin Receptor Blockers (ARB) andβreceptor blockers. Statins were most frequently used for blood lipid control. The qualification rate of FBG, SBP, DBP, TG, LDL-C in veteran cadres and community residents were 63.5%,26.1%,59.0%,51.9%, 52.2% and 25.0%,19.4%,25.5%,3.7%,27.5%, respectively (P<0.05). The qualification rate of HbA1C and HDL-C in the two groups were 51.4%,32.0% and 46.5%,35.7%, respectively (P>0.05). The qualification rate of blood sugar, blood pressure and blood lipid were 39.2%,22.4%,12.3% and 22.1%,7.7%,0.0%, respectively.To summarize, the annual conversion rate of IGT to diabetes mellitus was 5.7% and IGT could convert to diabetes mellitus in 74.2% patients.2h plasma glucose of OGTT was the key factor for the conversion of IGT to diabetes mellitus in senile patients. The treatment and qualification rate of metabolic syndrome should be improved. We must strengthen propaganda, do some early detection, therapy comprehensively of all metabolic disorders and improve the patients'compliance and self-management ability.