2 型糖尿病老年患者合并症的高发率：一项横断面调查。

High prevalence of comorbidities in older adult patients with type 2 diabetes: a cross-sectional survey.

机构信息

Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, Imam Khomeini Hospital Complex (IKHC), Tehran University of Medical Sciences, Tehran, Iran.

出版信息

BMC Geriatr. 2024 Oct 24;24(1):873. doi: 10.1186/s12877-024-05483-3.

DOI:10.1186/s12877-024-05483-3

PMID:39448921

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11515473/

Abstract

BACKGROUND

Diabetes is a global health problem, and its incidence and complications increase with the duration of the disease and over time. This increase in complications in older patients can lead to disability and a lower quality of life. This study aimed to investigate the rate of diabetes control and complications in older adults.

METHOD

This was a cross-section of an ongoing cohort of patients with type 2 diabetes mellitus (T2DM) aged 65 years and older. The clinical and laboratory characteristics of older adult patients with T2DM in good and intermediate health conditions were collected between 2010 and 2022.

RESULTS

A total of 2,770 older adult patients with T2DM were enrolled, including 1,530(55.3%) female and 1,240 (44.7%) male participants. Metabolic syndrome, hypertension, and coronary artery disease were the most common comorbidities, affecting 1,889 (71.4%), 1,495 (54.4%), and 786 (29.2%) patients, respectively. Albuminuria was present in 626 (22.6%) patients, while retinopathy was detected in 408 (14.7%) patients, including 6% with proliferative retinopathy. Most patients were treated with oral antidiabetic agents (88.9%), with metformin being the most prescribed medication (85.6%). Statins were prescribed to 71.8% of the patients. The most prescribed antihypertensive medications were angiotensin receptor blockers and angiotensin-converting enzyme inhibitors, prescribed to 54% and 15% of patients, respectively. The hemoglobin A1c (HbA1c) goal (HbA1c < 7.5%) was achieved in 1,350 (56.4%) patients, and the low-density lipoprotein cholesterol (LDL-C) goal (LDL < 100) was achieved in 1,165 (45.6%) patients. Blood pressure control (BP < 140/90) was achieved in 1,755 (65.4%) patients. All three goals were achieved in 278 (10.3%) patients. There were no significant differences in clinical laboratory results and the patients' characteristics based on gender.

CONCLUSION

The rate of progression of complications in older adult patients is higher than the effectiveness of the treatment, indicating the need for increased social support for this age group.

摘要

背景

糖尿病是一个全球性的健康问题，其发病率和并发症随着疾病的持续时间和时间的推移而增加。老年患者并发症的增加会导致残疾和生活质量下降。本研究旨在调查老年患者糖尿病控制和并发症的发生率。

方法

这是一项对 2010 年至 2022 年间年龄在 65 岁及以上的 2 型糖尿病（T2DM）患者进行的正在进行的队列研究的横断面研究。收集了处于良好和中等健康状况的老年 T2DM 患者的临床和实验室特征。

结果

共纳入 2770 例老年 T2DM 患者，其中女性 1530 例（55.3%），男性 1240 例（44.7%）。代谢综合征、高血压和冠心病是最常见的合并症，分别影响 1889 例（71.4%）、1495 例（54.4%）和 786 例（29.2%）患者。626 例（22.6%）患者存在白蛋白尿，408 例（14.7%）患者存在视网膜病变，其中 6%为增殖性视网膜病变。大多数患者接受口服降糖药物治疗（88.9%），其中二甲双胍的使用率最高（85.6%）。71.8%的患者接受他汀类药物治疗。最常开的降压药是血管紧张素受体阻滞剂和血管紧张素转换酶抑制剂，分别有 54%和 15%的患者使用。糖化血红蛋白（HbA1c）目标值（HbA1c＜7.5%）达标 1350 例（56.4%），低密度脂蛋白胆固醇（LDL-C）目标值（LDL＜100）达标 1165 例（45.6%）。血压控制（BP＜140/90）达标 1755 例（65.4%）。三项均达标 278 例（10.3%）。基于性别，患者的临床实验室结果和特征没有显著差异。