Bo Mario, Gallo Stefano, Zanocchi Mauro, Maina Paola, Balcet Luisa, Bonetto Martina, Marchese Lorenzo, Mastrapasqua Annalisa, Aimonino Ricauda Nicoletta
Department of Medical Sciences, Geriatric Section, University of Turin, 10124 Turin, Italy.
ASL TO4, 10034 Piemonte, Italy.
J Diabetes Res. 2015;2015:174316. doi: 10.1155/2015/174316. Epub 2015 Sep 6.
Prevalence, clinical correlates, and use of glucose-lowering drugs were comprehensively evaluated among 863 nursing home older patients with diabetes (mean age 82.9 ± 2.1 years): functional dependence and cognitive impairment were present in 84.1% and 68% of patients, respectively, and 66.3% of patients had 2-4 comorbidities. HbA1c values < 7.0% were documented in 54.9% of diabetic; significantly lower HbA1c levels were observed in demented patients than in nondemented subjects. Documented hypoglycemic episodes were reported for 57 patients (6.6%), without significant association with age, functional dependence, cognitive impairment, or HbA1c levels. About one-fifth of older long-term facilities residents have diabetes, with concomitant poor health conditions and high prevalence of cognitive impairment and functional dependence. Roughly three-fourths of these older and frail diabetic patients have HbA1c values lower than optimal, suggesting a potential for hypoglycemic harm especially among patients with severe cognitive impairment.
在863名患有糖尿病的养老院老年患者（平均年龄82.9±2.1岁）中，对糖尿病患病率、临床相关因素及降糖药物使用情况进行了全面评估：分别有84.1%和68%的患者存在功能依赖和认知障碍，66.3%的患者有2至4种合并症。54.9%的糖尿病患者糖化血红蛋白（HbA1c）值<7.0%；痴呆患者的HbA1c水平显著低于非痴呆患者。有57名患者（6.6%）报告有低血糖发作记录，与年龄、功能依赖、认知障碍或HbA1c水平无显著关联。约五分之一的老年长期护理机构居民患有糖尿病，同时健康状况较差，认知障碍和功能依赖患病率较高。这些年老体弱的糖尿病患者中约四分之三的HbA1c值低于最佳水平，提示尤其在严重认知障碍患者中存在低血糖危害的可能性。
