| Diabetes mellitus, the fifth leading cause of disease related death, has become a serious public health problem. This study investigated control of HbA1c, related influence factors, and hypoglycemic medication patterns in patients with elderly type 2 diabetes. The aim of the study was to provide actual data for optimizing and rationalizing hypoglycemic treatment in patients with elderly type 2 diabetes.This study consists of two parts. Part one:A comprehensive evaluation on health condition in patients with elderly type 2 diabetes, who had received long-term health care in our hospital, was performed in the year of 2009. These patients had taken integrated control measures on diabetes for years, including education, monitoring blood glucose, short in hospital treatment, etc. The results showed that, of the total 688 patients, the mean age was 76.8±9.9 (60-95) years, including 652 males and 36 females. The average level of HbAic was 6.6%±0.9% in all involved patients,50.6% of whom had HbA1c level less than 6.5%, 76.3% of whom had HbAic level less than 7.0%. In addition, blood total cholesterol (TC), blood low-density lipoprotein (LDL-C), blood high-density lipoprotein (HDL-C), blood triglyceride (TG), blood pressure and BMI were tested as normal value in 77.1%,46.4%,66.1%,67.8%,36.3%, and 57.4% of the 688 patients respectively. Duration of disease, type of treatment, HDL, TG, BMI, and blood pressure were significantly correlated with HbAjc control. In the last 10 years, no case admitted because of ketoacidosis and hyperosmolar nonketotic diabetic coma or died, while three got to hospital for hypoglycemiaPart two:Using cross-sectional and field survey methods,206 elderly type 2 diabetic patients were investigated. They were 108 patients treated in our hospital (the veteran group), and 98 patients followed up in a community in Beijing (the community group) in 2009. Hypoglycemic drug treatment patterns, costs and target blood glucose control were analyzed. The rationality and effectiveness of hypoglycemic drug treatment patterns among the two groups were compared by evaluating blood HbA1c levels. It was found that metformin and acarbose were the major adopted hypoglycemic drugs, which were used in about half of patients in both groups. According to the diabetic control standard in "Chinese Type 2 Diabetes Prevention Guide", the patients, whose fasting blood glucose (FBG) and HbA1c were controlled well constituted 64.8% and 41.7% in veteran group respectively, higher than that in community group (11.2% and 26.5%, respectively). The effective control rate of TC, TG, LDL-C and HDL-C in veteran group was also significantly higher than that in community group. The average daily costs of hypoglycemic agents were higher in veteran group than that in community group. The average daily costs of hypoglycemic agents less than 10 yuan accounted for 46.3% in veteran group and 73.5% in community group. Combined using of two or more kinds of hypoglycemic drugs accounted for 66.7% in veteran group, compared with 53.1% in the community group. A small number of patients still took glibenclamide and phenformin in community group.To summarize, the relative effective control of diabetes in our study, compared to previous studies, could be attributed to long-term effective comprehensive management. The hypoglycemic drug treatment patterns in both groups were basically similar. The rationality of drug usage in the veteran group was superior to that in the community group, and the control effectiveness of the indexes in blood glucose and lipid were better in the veteran group than that in the community group, which might be attributed to combination therapy with more hypoglycemic agents and higher costs.
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