| Objective:To investigate the status of control,complications and comorbidities of elderly patients with type 2 diabetes in some 3 A grade hospital of Yunnan province,and to guide the comprehensive prevention and treatment of elderly patients with T2DM.Methods:151 patients with type 2 Diabetes mellitus(T2DM)from October 2015 to May 2016 were enrolled.They were eligible for WHO 1999 DM diagnostic criteria.and recruited from the first affiliated hospital of Kunming Medical University,the Second Affiliated Hospital of Kunming Medical University,the Kunming General Hospital of Chengdu Military Region,the Yuxi People’s Hospital of Yunnan,and the Chuxiong People’s Hospital,Their diabetes have been treated more than one year.General information,anthropometric and biochemical data,including age,gender,education level,duration of diabetes,chronic disease,Waist-to-hip circumference,height and weight,waist-to-hip ratio(WHR),body mass index(BMI),systolic blood pressure(SBP),diastolic blood pressure(Diastolic blood pressure,DBP),glycosylated hemoglobin(Hb Ale),total cholesterol(TC),triglyceride acid(TG),high-density lipoprotein(HDL-C),low density lipoprotein lipoprotein(LDL-C)and the presence of diabetic nephropathy,diabetic retinopathy,diabetic neuropathy,and drug use situation were recorded.The goals of diabetes control were based on the,Experts Consensus of Diagnosis and Treatment Measures for The Chinese Elderly Patients with Type 2 Diabetes(2018 Edition)"with attempt to understand the status of metabolic control and complications and comorbid conditions in elderly patients with diabetes;All data were statistically analyzed by SPSS software(22.0 version)The qualitative data were expressed as percentage,and the chi-square test was used for comparison.Quantitative data were expressed as mean ± standard deviation or median(interquartile range)for non-normal distribution data;Rank data were analyzed by Spearman correlation.Results:1.Metabolic indices:BMI of the elder T2DM was(24.41±3.08)kg/m2,male WHR was(0.96±0.08),female WHR was(0.95±0.09),BP was(136.30±15.53)/(76.30±9.72)mmHg;TC was(4.48 ± 1.08)mmol/L,TG was[1.57(1.08,2.13)]mmol/L,male HDL-C was[1.08(0.92,1.24)]mmol/L,female HDL-C was[1.12(0.95,1.38)]mmol/L,respectively.LDL-C of patients with and without coronary heart disease were(2.92±0.86)mmol/L and(2.92±0.86)mmol/L;HbAlc,FPG,PBG were(8.80±2.14)%,(9.01±3.3)mmol/L,and(13.90±5.03)mmol/L.The compliance rate of both BMI,BP,HbAlc,and lipids were 51.0%,55.0%,20.5%,13.9%,3B(blood pressure,blood glucose,and blood)compliance rate was 4.0%,and the compliance rate of BMI+BP+lipids+HbAle was only 2.0.%.2.Complications:The acute complications of diabetes in elderly patients with T2DM was 33.8%,the highest prevalence of hypoglycemia among these hospitals was 19.2%.The prevalence of diabetic ketoacidosis,hyperglycemia hyperosmolarity status,severe infection were 17.0%,2.6%and 0.7%,respectively.For chronic complications,the prevalence of diabetic retinopathy,diabetic nephropathy,diabetic peripheral neuropathy and diabetic foot were 37.7%,19.9%,49.7%,and 4.6%.3.Comorbidities:There were 147 patients(97.4%)had comorbidities.The major types of comorbidities were dyslipidemia(84.8%),hypertension(71.5%),fatty liver(45.7%).Most patients had 2-4 comorbidities,accounted for 74.8%;For patients in the 60-69 age,70-79 age and 80-90 age,the incidence of comorbidities were 96.6%,96.4%,100%,respectively,and there was no statistically significant difference among different age groups.However,the numbers of comorbidities were significantly correlated with age.With aging,the numbers of comorbidities in elderly T2DM patients were increasing.4.The use rate of hypoglycemic drugs was 33.9%,the therapeutic rate of insulin was 16.1%,the therapeutic rate of drugs with 2 or more was 16.1%,and the use rate of lipid-lowering drugs was 23.2%.Conclusions:1.Elderly patients with diabetes in some 3A grade hospital of our province had poorer glycemic control,because they had older age,longer course of disease,lower education level,higher prevalece of chronic complications and comorbidities.2.Oral drugs,initial treatment of insulin and combination therapy with hypoglycemic drugs started late:doctors need to renew their therapeutie strategies and individualized glycemic control goals should be stratified for elderly diabetic patients,in order to improve the level of blood glucose control in elderly diabetes.3.3B compliance rate was only 4.0%,suggesting doctors should strengthen the control of BP and lipids,which accounted for most common comorbidities.Comprehensive management is very important. |
