Juan Carlos Durán Alonso1. 1. Servicio de Geriatría, Hospital Juan Grande, Jerez, Cádiz, España. juancaduran@ono.com
Abstract
OBJECTIVE: To determine prevalence and clinical characteristics of elderly diabetic patients in nursing homes. MATERIAL AND METHOD: Observational and multicentre study in 14 nursing homes in Cádiz (Spain). STUDY VARIABLES: age, sex, prevalence of diabetes, duration of diabetes, complications, macrovascular complications, retinopathy, nephropathy, and neuropathy. Metabolic control: frequency of baseline blood glucose and HbA1c determinations. Metabolic complications suffered. TREATMENT: oral and type of antidiabetics, insulinisation. Diabetes education. Functional and mental assessment using Barthel index and MMT. Data was analysed using SPSS v17.0. RESULTS: A total of 1952 elderly institutionalised patients were studied, with a diabetes prevalence of 26.44%. The study included 312 patients with a mean age of 79.7 years, of whom 57.4% were women, and 66.9% knew of their diagnosis of diabetes for over 10 years. Vascular events were suffered by 55.1%, with the most common being ischaemic stroke (55.2%), followed by myocardial infarction (18%) and 14.5% with peripheral arterial disease. There were 29.6% with retinopathy, 21.3% diabetic nephropathy, and 25.6% suffering from distal symmetric polyneuropathy. HbA1c analysis was performed in 90.1% of patients, with 50% levels between 7 and 9%, with a six-monthly assessment rate of 63.4%. Metabolic complications: diabetic ketoacidosis 7.1%, hyperosmolar syndrome 2.9%, and 15.7% symptomatic hypoglycaemia. Oral hypoglycaemic agents were being taken by 66% of patients, with the most frequently used being metformin (55.3%) followed by gliclazide and repaglinide (10.2%, 3.4%, respectively). 50.2% were insulinised. 45.6% functional dependence. Barthel Index average of 48.4 points, with 46.1% diagnosed with dementia, moderate state, 36.7%. CONCLUSIONS: Diabetic prevalence in nursing homes is high, and institutionalised patients are elderly, long-standing diabetics, with both macro- and microvascular complications, and have a significant level of mental and functional disabilities.
OBJECTIVE: To determine prevalence and clinical characteristics of elderly diabeticpatients in nursing homes. MATERIAL AND METHOD: Observational and multicentre study in 14 nursing homes in Cádiz (Spain). STUDY VARIABLES: age, sex, prevalence of diabetes, duration of diabetes, complications, macrovascular complications, retinopathy, nephropathy, and neuropathy. Metabolic control: frequency of baseline blood glucose and HbA1c determinations. Metabolic complications suffered. TREATMENT: oral and type of antidiabetics, insulinisation. Diabetes education. Functional and mental assessment using Barthel index and MMT. Data was analysed using SPSS v17.0. RESULTS: A total of 1952 elderly institutionalised patients were studied, with a diabetes prevalence of 26.44%. The study included 312 patients with a mean age of 79.7 years, of whom 57.4% were women, and 66.9% knew of their diagnosis of diabetes for over 10 years. Vascular events were suffered by 55.1%, with the most common being ischaemic stroke (55.2%), followed by myocardial infarction (18%) and 14.5% with peripheral arterial disease. There were 29.6% with retinopathy, 21.3% diabetic nephropathy, and 25.6% suffering from distal symmetric polyneuropathy. HbA1c analysis was performed in 90.1% of patients, with 50% levels between 7 and 9%, with a six-monthly assessment rate of 63.4%. Metabolic complications: diabetic ketoacidosis 7.1%, hyperosmolar syndrome 2.9%, and 15.7% symptomatic hypoglycaemia. Oral hypoglycaemic agents were being taken by 66% of patients, with the most frequently used being metformin (55.3%) followed by gliclazide and repaglinide (10.2%, 3.4%, respectively). 50.2% were insulinised. 45.6% functional dependence. Barthel Index average of 48.4 points, with 46.1% diagnosed with dementia, moderate state, 36.7%. CONCLUSIONS:Diabetic prevalence in nursing homes is high, and institutionalised patients are elderly, long-standing diabetics, with both macro- and microvascular complications, and have a significant level of mental and functional disabilities.