Diabetes control in Swedish community dwelling elderly: more often tight than poor

J Intern Med. 2004 Jan;255(1):96-101. doi: 10.1046/j.1365-2796.2003.01261.x.

Abstract

Objective: To determine glycaemic control in elderly patients with diabetes living in community dwelling.

Design: Descriptive, cross-sectional and open. Prospective with regard to blood glucose.

Setting: Community-dwelling in-patients.

Subjects: From a total number of 351 patients in seven Swedish centres of community dwelling we identified and recruited all 45 patients with diabetes receiving treatment with insulin, and/or oral medication.

Main outcome measures: Blood glucose was measured fasting, 2 h after breakfast, in the evening and at night, for three consecutive days.

Results: Mean HbA1c was 5.9 +/- 1.1% (range 3.6-8.6%). The patients were split in three HbA1c-groups for analysis: lower- (3.6-5.3%), middle- (5.4-6.3%) and higher-tertile (6.4-8.6%). The groups where similar with regard to age, time in community dwelling, ability to eat and move around independently, but body mass index was lower in the lower tertile (P < 0.003 and P < 0.04, compared with middle- and higher-tertiles). We recorded 14 episodes with blood glucose </=4.0 mmol L-1 in eight patients. Blood glucose </=4.0 mmol L-1 was mostly recorded during night (n = 8) or in the morning (n = 3).

Conclusions: Swedish patients with diabetes in community dwelling are over- rather than under-treated and have low HbA1c levels. Despite very regular eating habits and near total compliance with medication, hypoglycaemias are frequent and possibly linked to malnutrition.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Glucose / analysis*
  • Cross-Sectional Studies
  • Diabetes Complications
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / prevention & control*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / prevention & control
  • Female
  • Glycated Hemoglobin A / analysis
  • Housing for the Elderly
  • Humans
  • Hypoglycemia / blood
  • Hypoglycemia / drug therapy
  • Hypoglycemia / etiology
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Patient Compliance
  • Prospective Studies

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin