Current status of diabetes management in elderly Koreans with diabetes

Knowledge about the current status of diabetes management is indispensable for the improvement of diabetes management. We performed a survey to investigate the current trend of diabetes management in elderly Koreans, at eight hospitals located throughout the country. A total of 539 patients with type 2 diabetes older than 65 years (men = 224, women = 315) were recruited. Their mean age was 71.5 ± 4.9 years and BMI 24.3 ± 3.4 (men = 23.6 ± 2.8, women = 24.9 ± 3.7) kg/m², and 38.2% of the patients were obese (BMI ≥ 25 kg/m², men = 29.5%, women = 44.4%). The mean duration of the diabetes was 13.1 ± 9.2 years. Although 37.3% of the patients had A1C below 7.0%, 33.8% of the patients had A1C more than 8.0%. Three hundred and sixty three patients (67.4%) were treated with oral hypoglycemic agents and 175 patients (32.5%) were treated with insulin or combination with oral agents. The glycemic control was better in patients treated with oral agents (oral agent group = 7.7 ± 4.6%, insulin group = 8.5 ± 1.9%). Although mean SBP and DBP were 131.4 ± 16.7 and 75.9 ± 10.4 mmHg, respectively, 67.4% of the patients had hypertension and 38.2% of the patients with hypertension did not reach the goal (<130/80 mmHg). Of 539 elderly patients, 253 patients (47.4%) had dyslipidemia (LDL-C ≥ 4.1 mmol/l and/or triglyceride ≥ 2.5 mmol/l and/or HDL-C < 1.1 mmol/l) and 72.7% of the patients with dyslipidemia took the lipid lowering agents. However, 47.4% of them did not achieve the goal (LDL-C < 2.6 mmol/l and/or triglyceride < 1.7 mmol/l and/or HDL-C > 1.1 mmol/l). Twenty-eight patients (5.5%) had been admitted to the hospital because of severe hypoglycemia. Half of the patients (57%) had microvascular complications (retinopathy, neuropathy or overt proteinuria), and 28% of the patients had macro-vascular complications (CVD, stroke or peripheral vascular disease). As elderly diabetic patients are usually polymorbid, diabetes mellitus in old age is needed a more comprehensive approach to not only the treatment of hyperglycemia but also of hypertension, dyslipidemia and other associated diseases.