The article is devoted to one of the most pressing medical problems diabetes mellitus type 2.
Objective: To study the peculiarities of the course of diabetes mellitus type 2 in persons over 65 years of age; to evaluate the effectiveness of different therapy regimens for the level of HbA1C.
Material and methods: The retrospective study included 100 patients with type 2 diabetes (T2D). The age of the patients: 65 to 82 years. The effectiveness of the prescribed treatment was assessed by the level of HbA1C. The compensation criterion for T2D was chosen to reach the level of HbA1C < 7.5% (for patients aged < 75 years) and HbA1C < 8.0% (for patients over 75 years).
Results: Patients were divided into two age groups: 6575 years old (80 people, 80%) and 75 years old and older (20 people, 20%). It was determined that the recommended HbA1C values were not observed in elderly and senile patients with different frequencies: they exceeded the recommended level of incidence (7.5%) - 75% of patients in the age group 6575 years old and 40% of patients in the group over 75 years old (threshold HbA1C=8.0%). The grouping of patients according to the modes of therapy (monoinsulin therapy and combination therapy) showed that the group of monoinsulin therapy with the target level of HbA1C exceeded 7.5% (6575 years) was 22 people. (37.9%) and HbA1C exceeded 8% (over 75 years of age) by 4 people. (80%), and in the group of combined therapy such patients were 36 people. (62%) and 4 people. (50%) was responsible. Thus, the total number of patients who exceeded the recommended level was 66 people. (66%). The analysis has shown that in combination therapy insulin is prescribed in doses that do not provide adequate control of glycaemia. More than half of the patients have high levels of HbA1C, and, therefore, an increased risk of development and progression of late complications of the disease. In our study, all 100% of patients had chronic complications with diabetes mellitus.
Conclusions: 1. Excess of the recommended level of HbA1C is more frequent in patients aged 6575. 2. Patients over 75 years of age are compensated in 60% of cases; 6575 years of age are compensated in only 25%.
18 - 21 May 2019
European Society of Endocrinology