Wisit Kaewput1, Charat Thongprayoon2, Mathirut Mungthin3, Sarawut Jindarat3, Narittaya Varothai4, Picha Suwannahitatorn5, Ram Rangsin1, Michael A Mao6, Wisit Cheungpasitporn7. 1. Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand. 2. Department of Internal Medicine, Bassett Medical Center, New York City, New York, USA. 3. Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, Thailand. 4. Medicine, Geriatric Unit, Phramongkutklao College of Medicine, Bangkok, Thailand. 5. Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand. 6. Department of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA. 7. Division of Nephrology/Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Abstract
BACKGROUND: This study aimed to assess the nationwide trends in optimal diabetic care and complications of elderly type 2 diabetes mellitus (T2DM) patients over a 6-year period in Thailand. METHODS: T2DM patients aged 65 years or older who received medical care at public hospitals in Thailand from 2010 to 2015 were included. The optimal T2DM care in elderly patients was defined as (1) blood pressure (BP) < 140/90, (2) hemoglobin A1C (HbA1c) < 7%, (3) low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL, (4) use of antiplatelet medications, and (5) use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) in hypertensive patients. T2DM treatment-related complications included hospital admissions due to dysglycemia. RESULTS: A total of 54 295 elderly T2DM patients were enrolled in this study. From 2010 to 2015, there was an increasing trend in the achievement of BP control and use of antiplatelet medications (P for trend < 0.01), whereas there was a decreasing trend in the achievement of HbA1c and LDL-C control among elderly T2DM patients (P for trend < 0.001). There was an increasing trend in the use of ACEI/ARB among elderly T2DM patients with hypertension (P for trend < 0.001). Hospital admissions due to dysglycemia decreased over the study period (P for trend < 0.001). CONCLUSION: There has been a trend change for diabetic care among elderly T2DM patients in Thailand. Further studies are needed to assess the impact on patient outcomes.
BACKGROUND: This study aimed to assess the nationwide trends in optimal diabetic care and complications of elderly type 2 diabetes mellitus (T2DM) patients over a 6-year period in Thailand. METHODS: T2DM patients aged 65 years or older who received medical care at public hospitals in Thailand from 2010 to 2015 were included. The optimal T2DM care in elderly patients was defined as (1) blood pressure (BP) < 140/90, (2) hemoglobin A1C (HbA1c) < 7%, (3) low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL, (4) use of antiplatelet medications, and (5) use of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) in hypertensivepatients. T2DM treatment-related complications included hospital admissions due to dysglycemia. RESULTS: A total of 54 295 elderly T2DM patients were enrolled in this study. From 2010 to 2015, there was an increasing trend in the achievement of BP control and use of antiplatelet medications (P for trend < 0.01), whereas there was a decreasing trend in the achievement of HbA1c and LDL-C control among elderly T2DM patients (P for trend < 0.001). There was an increasing trend in the use of ACEI/ARB among elderly T2DM patients with hypertension (P for trend < 0.001). Hospital admissions due to dysglycemia decreased over the study period (P for trend < 0.001). CONCLUSION: There has been a trend change for diabetic care among elderly T2DM patients in Thailand. Further studies are needed to assess the impact on patient outcomes.
Authors: Hongjiang Wu; Eric S H Lau; Aimin Yang; Ronald C W Ma; Alice P S Kong; Elaine Chow; Wing-Yee So; Juliana C N Chan; Andrea O Y Luk Journal: Cardiovasc Diabetol Date: 2020-05-12 Impact factor: 9.951