Jain Archana, Paranjape Shilpa
Department of Medicine, Neeri Hospital, CSIR-National Environmental Engineering Research Institute, Nagpur, Maharashtra, India.
Indian J Endocrinol Metab. 2013 Oct;17(Suppl 1):S318-22. doi: 10.4103/2230-8210.119647.
In 2011 census, 5.3% of the Indian population was > 65 years of age. This number has steadily grown over past few years and is steeply growing. Healthcare burden of elderly diabetics is immense and proper diagnosis and treatment alone can prevent further complications. According to the most recent surveillance data in U.S., the prevalence of diabetes among U.S. adults aged ≥65 years varies from 22 to 33%, depending on the diagnostic criteria used. In CSIR-NEERI, India, we have healthcare system wherein a fixed and limited number of patients are treated for their lifetime by qualified practitioners with negligible financial burden of the treatment costs. The patients have regular monthly follow up and hence we diagnose Diabetes and evaluate the control and diagnose micro vascular and macro vascular complications in all patients. We did retrospective analysis of all elderly patients following up in NEERI Hospital to find the exact prevalence of T2DM in elderly. It was observed that from total 585 elderly people, 178 had T2DM (30.42%- Prevalence). The sex ratio of Diabetic males to females was almost equal (1:0.97). Obesity was present in 114 people (64%). High prevalence of hypertension was found in Diabetic elderly population (80%). Comparing our prevalence rates with few other studies, it was found that our prevalence rates are quite high. The contributing factors may be urban living, with high prevalence of central obesity and Asian ethnicity, over and above, data of all patients undergoing treatment is available. We treated all diabetics with persistent values of Systolic BP > 130 mm of Hg and Diastolic values of BP > 80mm of Hg as Hypertensives, in order to achieve reduction in cardiovascular mortality and morbidity. This paper is for awareness of disease burden, in real primary care setup. It is not cross-sectional study but study with 100% inclusion of beneficiaries'. This is real world urban diabetes prevalence, also associated hypertension and central obesity prevalence.
在2011年的人口普查中,5.3%的印度人口年龄超过65岁。这一数字在过去几年中稳步增长,且仍在急剧上升。老年糖尿病患者的医疗负担巨大,只有进行正确的诊断和治疗才能预防进一步的并发症。根据美国最新的监测数据,65岁及以上美国成年人中糖尿病的患病率在22%至33%之间,具体取决于所使用的诊断标准。在印度的CSIR-NEERI,我们拥有这样一个医疗体系:一定数量且固定的患者由合格的医生进行终身治疗,治疗费用的经济负担微乎其微。患者每月定期随访,因此我们对所有患者进行糖尿病诊断、评估血糖控制情况,并诊断微血管和大血管并发症。我们对NEERI医院所有接受随访的老年患者进行了回顾性分析,以确定老年2型糖尿病的确切患病率。结果发现,在总共585名老年人中,有178人患有2型糖尿病(患病率为30.42%)。糖尿病男性与女性的性别比几乎相等(1:0.97)。114人(64%)存在肥胖问题。在糖尿病老年人群中发现高血压的患病率很高(80%)。将我们的患病率与其他一些研究进行比较后发现,我们的患病率相当高。促成因素可能包括城市生活、中心性肥胖患病率高以及亚洲种族,此外,所有接受治疗患者的数据都是可获取的。为了降低心血管疾病的死亡率和发病率,我们将收缩压持续高于130毫米汞柱且舒张压高于80毫米汞柱的所有糖尿病患者视为高血压患者进行治疗。本文旨在提高对实际基层医疗环境中疾病负担的认识。这不是横断面研究,而是对所有受益患者进行100%纳入的研究。这是真实世界中的城市糖尿病患病率,以及与之相关的高血压和中心性肥胖患病率。