Questions under study: The prevalence of diabetes mellitus in the older population is high, but hardly any data are available on current diabetes care in the primary care setting. We aimed at investigating the diabetes management of older patients with type 2 diabetes (T2DM) in the primary care setting, including adherence to current guidelines, comparing patients aged 70-79 years to those aged 80 years and above.
Methods: From November 2008 through March 2009 a total of 23 primary care physicians and one consultant in internal medicine consecutively enrolled 203 unselected patients with T2DM aged ≥70 years.
Results: From the 203 study participants 66% were 70-79 years of age, and 34% were 80 years or older. Mean HbA1c and LDL-cholesterol were not significantly different between the older and the younger age group (7.6 ± 1.6 vs. 7.1 ± 0.9%; p = 0.080; and 122 ± 40 vs. 114 ± 34 mg/dl; p = 0.273), whereas BMI was lower (27.5 ± 5.0 vs. 29.6 ± 5.0 kg/m2, p = 0.010), and the prevalent rates of coronary heart disease (55.1 vs. 37.1%, p = 0.011) and of dementia (29% vs. 6.1%, p = 0.001) were higher in the older age group. LDL-cholesterol (77.6% vs. 66.7%, p = 0.012), creatinine clearance (34.6% vs. 30.9%, p = 0.049) but not HbA1c (74.6% vs.73.9; p = 0.520) were monitored significantly less often in the older than in the younger age group.
Conclusions: While glycaemic control on average appears strict, there may be ample room for improvement in reaching lipid targets and in the monitoring of lipid and renal function among older adults in primary care, in particular among individuals aged ≥80 years.