Department of Internal Medicine, Division of Geriatric Medicine, Faculty of Medicine, Gaziantep University, 27100 Gaziantep, Turkey.
Medicina (Kaunas). 2021 Sep 15;57(9):968. doi: 10.3390/medicina57090968.
Type 2 diabetes is one of the common chronic diseases in the elderly. It is thought that long-term complications of type 2 diabetes will negatively affect the quality of life in elderly individuals. It is possible that geriatric syndromes, especially frailty syndrome, are associated with diabetic complications, too. In this study, we aimed to evaluate the effect of macrovascular and microvascular complications of type 2 diabetes on frailty and other geriatric syndromes. In addition, the effect of these complications on quality of life was also reviewed. : We conducted a cross-sectional study for four months. Comprehensive geriatric assessment tests were done on all patients. The Fried frailty index (FFI) was used for the evaluation of frailty syndrome. We assessed malnutrition by mini nutritional assessment short-form (MNA-SF), and Global Leadership Initiative on Malnutrition criteria (GLIM). The EWGSOP 2 criteria were used for the diagnosis of sarcopenia. Quality of life (QoL) was evaluated using the short form-36 (SF-36) questionnaire. Data analysis was done by SPSS version 22. 237 females and 142 males with a mean age of 71.7 ± 6.1 years were included in the study. The frequency of macrovascular and microvascular complications was 41.4% and 68.1%, respectively. Frailty was found to be associated with macrovascular complications ( = 0.003). Handgrip strength, skeletal muscle mass index, and gait speed were decreased in the presence of macrovascular complications ( = 0.043, < 0.001, < 0.001). QoL was also decreased in patients with macrovascular complications ( = 0.003). Nutritional status and handgrip strength were negatively affected in patients with diabetic neuropathy ( = 0.019, = 0.014). Polypharmacy was also found to be associated with macrovascular complications ( < 0.001, < 0.001). Macrovascular complications were 2.5 times more common in malnourished patients according to GLIM and 3.2 times more common in patients with decreased gait speed. In this study, we observed that both macrovascular and microvascular complications of diabetes increase susceptibility to geriatric syndromes in elderly individuals. It could be useful to conduct prospective studies in which we can compare the effectiveness of treatment methods on this subject.
2 型糖尿病是老年人常见的慢性疾病之一。据认为，2 型糖尿病的长期并发症会对老年人的生活质量产生负面影响。老年综合征，特别是衰弱综合征，也可能与糖尿病的并发症有关。在这项研究中，我们旨在评估 2 型糖尿病的大血管和微血管并发症对衰弱和其他老年综合征的影响。此外，还回顾了这些并发症对生活质量的影响。
我们进行了为期四个月的横断面研究。对所有患者进行了全面的老年综合评估测试。使用 Fried 衰弱指数（FFI）评估衰弱综合征。我们通过微型营养评估简表（MNA-SF）和全球营养不良倡议标准（GLIM）评估营养不良。EWGSOP 2 标准用于诊断肌少症。使用简短形式 36 项（SF-36）问卷评估生活质量（QoL）。数据分析使用 SPSS 版本 22。
研究纳入了 237 名女性和 142 名男性，平均年龄为 71.7 ± 6.1 岁。大血管和微血管并发症的发生率分别为 41.4%和 68.1%。衰弱与大血管并发症有关（ = 0.003）。存在大血管并发症时，手握力、骨骼肌质量指数和步态速度降低（ = 0.043， < 0.001， < 0.001）。大血管并发症患者的生活质量也降低（ = 0.003）。患有糖尿病神经病变的患者，营养状况和手握力受到负面影响（ = 0.019， = 0.014）。还发现大剂量用药与大血管并发症有关（ < 0.001， < 0.001）。根据 GLIM，营养不良的患者发生大血管并发症的几率是正常营养患者的 2.5 倍，而步态速度降低的患者发生大血管并发症的几率是正常步态速度患者的 3.2 倍。
在这项研究中，我们观察到糖尿病的大血管和微血管并发症都会增加老年人发生老年综合征的易感性。在这个课题上进行前瞻性研究比较治疗方法的效果可能会很有用。
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