Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Malaysia.
Exp Gerontol. 2013 May;48(5):485-91. doi: 10.1016/j.exger.2013.02.017. Epub 2013 Feb 27.
Providing effective medical care for older patients with type 2 diabetes mellitus (T2D) that may contribute to their active aging has always been challenging. We examined the independent effect of age ≥ 60 years on disease control and its relationship with diabetes-related complications in patients with T2D in Malaysia. This was a cross-sectional study using secondary data from the electronic diabetes registry database Adult Diabetes Control and Management (ADCM). A total of 303 centers participated and contributed a total of 70,889 patients from May 2008 to the end of 2009. Demographic data, details on diabetes, hypertension, dyslipidemia and their treatment modalities, various risk factors and complications were updated annually. Independent associated risk factors were identified using multivariate regression analyses. Fifty-nine percent were female. Malay comprised 61.9%, Chinese 19% and Indian 18%. There were more Chinese, men, longer duration of diabetes and subjects that were leaner or had lower BMI in the older age group. Patients aged ≥ 60 years achieved glycemic and lipid targets but not the desired blood pressure. After adjusting for duration of diabetes, gender, ethnicity, body mass index, disease control and treatment, a significantly higher proportion of patients ≥ 60 years suffered from reported diabetes-related complications. Age ≥ 60 years was an independent risk factor for diabetes-related complications despite good control of cardiovascular risk factors. Our findings caution against the currently recommended control of targets in older T2D patients with more longstanding diseases and complications.
为患有 2 型糖尿病（T2D）的老年患者提供有效的医疗护理，以促进其积极老龄化，这一直是具有挑战性的。我们研究了年龄≥60 岁对疾病控制的独立影响及其与马来西亚 T2D 患者糖尿病相关并发症的关系。这是一项使用电子糖尿病登记数据库成人糖尿病控制和管理（ADCM）的二级数据分析的横断面研究。共有 303 个中心参与，共贡献了 70889 名患者，数据采集时间为 2008 年 5 月至 2009 年底。每年更新人口统计学数据、糖尿病、高血压、血脂异常及其治疗方式、各种危险因素和并发症的详细信息。使用多元回归分析确定独立的相关危险因素。59%为女性。马来人占 61.9%，中国人占 19%，印度人占 18%。在年龄较大的组中，中国人、男性、糖尿病病程较长以及较瘦或 BMI 较低的患者更多。≥60 岁的患者实现了血糖和血脂目标，但血压未达到理想水平。在调整了糖尿病病程、性别、种族、体重指数、疾病控制和治疗后，≥60 岁的患者中报告有更多的糖尿病相关并发症。尽管心血管危险因素得到了很好的控制，但年龄≥60 岁是糖尿病相关并发症的独立危险因素。我们的研究结果提醒人们注意，对于患有更长期疾病和并发症的老年 2 型糖尿病患者，目前推荐的目标控制可能并不合适。
