Ma Yanhua, Zhao Yan, Wei Ran, Qiao Jingtao, Luo Jingyi, Zhang Lina, Zhang Jie, Deng Mingqun, Yu Yang, Wang Weihao, Pan Qi, Guo Lixin
Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
Front Pharmacol. 2025 Apr 7;16:1549244. doi: 10.3389/fphar.2025.1549244. eCollection 2025.
With the aging of population, the proportion of elderly patients with diabetes is gradually increasing, which poses challenges in the management and treatment of diabetes in this population.
The aim of the study was to investigate the temporal changes in the treatment regimens and medical expenditures in older patients with diabetes in Beijing, China. Data of patients with diabetes from the Beijing Medical Insurance Database with medical records from 2016 to 2018 were retrospectively analyzed. Primary and secondary outcomes included the number of medications, comorbidities, diabetes-related complications, the estimated annual drug cost, the treatment strategies for elderly diabetic patients, and the classes of drugs prescribed.
Data of 598,440 patients with diabetes in 2018 revealed that 49.8% of the recruited patients were female among elderly patients (>65 years old). The most common comorbidity was hypertension (87.6%). Over the 3 years, about 4.51 medications, including 1.88 antiglycemic drugs and 2.63 non-antiglycemic drugs were prescribed in elderly patients. The mean total annual medication cost was ¥12,186 ($1,676), including ¥6,116 ($841) for antiglycemic drugs and ¥6,070 ($835) for non-antiglycemic drugs. Hypertension (cost ¥4,658, $640, mean medications 2.12 for elderly patients), dyslipidemia (¥5,044, $693, 1.70), and coronary heart disease (¥4,004, $550, 1.40) were the top three diseases that caused the increase in the cost and medications. Over the 3 years, more than 94% of elderly diabetic patients received at least one type of antiglycemic drugs, and the α-glucosidase inhibitors and premixed insulin are the most commonly prescribed hypoglycemic drugs and insulin, respectively.
Diabetes management in older patients faces challenges due to extensive variability. Medication analysis in this study found that the current situation of comprehensive control of diabetes in elderly patients is worrying, and the complexity of their medication is still on the increasing trend. It is important to select more appropriate antiglycemic drugs to economically benefit the patients and to control the progression of complications.
随着人口老龄化，老年糖尿病患者的比例逐渐增加，这给该人群糖尿病的管理和治疗带来了挑战。
本研究旨在调查中国北京老年糖尿病患者治疗方案和医疗费用的时间变化。对来自北京医疗保险数据库的2016年至2018年有病历记录的糖尿病患者数据进行回顾性分析。主要和次要结局包括用药数量、合并症、糖尿病相关并发症、估计年度药物费用、老年糖尿病患者的治疗策略以及所开药物的类别。
2018年598440例糖尿病患者的数据显示，在老年患者（>65岁）中，49.8%的招募患者为女性。最常见的合并症是高血压（87.6%）。在这3年中，老年患者平均开出约4.51种药物，其中包括1.88种降糖药和2.63种非降糖药。年平均药物总费用为12186元（1676美元），其中降糖药6116元（841美元），非降糖药6070元（835美元）。高血压（老年患者费用4658元，640美元，平均用药2.12种）、血脂异常（5044元，693美元，1.70种）和冠心病（4004元，550美元，1.40种）是导致费用和用药增加的前三种疾病。在这3年中，超过94%的老年糖尿病患者接受了至少一种降糖药治疗，α-葡萄糖苷酶抑制剂和预混胰岛素分别是最常开具的降糖药和胰岛素。
老年患者的糖尿病管理因广泛的变异性而面临挑战。本研究中的用药分析发现，老年患者糖尿病综合控制的现状令人担忧，其用药复杂性仍呈上升趋势。选择更合适的降糖药以让患者获得经济实惠并控制并发症进展很重要。
