Abstract

LINANA-GRANELL, C; ROMERO-DEL BARCO, R; MERCADAL-ORFILA, G  and  BLASCO-MASCARO, I. Glycemic control in the elderly patient with type 2 diabetes mellitus treated with antidiabetics. Rev. OFIL·ILAPHAR [online]. 2022, vol.32, n.1, pp.29-33.  Epub Nov 21, 2022. ISSN 1699-714X.  https://dx.doi.org/10.4321/s1699-714x2022000100006.

The objective of this work is to evaluate antidiabetic treatment and concordance with the glycosylated hemoglobin (HbA1c) values recommended by the guidelines in elderly patients: between 7.5 and 8.5% for the control of type II diabetes mellitus (DMII) in frail elderly patients. HbA1c <6.5% is being associated with higher morbidity and mortality, risk of hypoglycemia and falls.

This is a retrospective study conducted in January 2020. Patients diagnosed with DMII, older than 75 years, who had been treated with any combination of oral antidiabetic drugs (ADO) were included. The last HbA1c value available during the previous year was recorded. The relationship between the HbA1c value and the number of prescribed ADOs (+ insulin), age of the patient and/or frailty was analyzed.

936 patients were included, mean age 81.3 years. 15.8% of the patients had no HbA1c determination available in the last year. The rest of the patients had a mean HbA1c of 6.6%. Only 13.2% of the patients were in the target therapeutic range (7.5-8.5%). 39.9% had an HbA1c <6.5% and only 5.0% had an HbA1c ≥8.5%, (poor control). Of the 617 patients with an HbA1c <7.5%, 25.4% were older than 85 years, 32.1% were classified as complex chronic patient (PCC), which meant greater frailty, 38.6% had more than one ADO drug and 8.6% had associated insulin.

The HbA1c values in the analyzed elderly patients are lower than those recommended by the main guidelines. The results of this work make clear the need to implement strategies that establish the optimal treatment individually.

Keywords : Diabetes; elderly; glycosylated hemoglobin.

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