Diabetes in the very elderly: need for an individualised approach

S. Bellary, A. Oluwatoyin

Research output: Contribution to journalConference abstract

Abstract

Background: Intensive risk factor management is recommended for individuals with diabetes. However, it is not known if such an approach is appropriate in the elderly with multiple comorbidities and limited life expectancy. The aim of this study was to characterise a cohort of very elderly individuals with diabetes and assess the impact of known risk factors on mortality.
Methods: This was a retrospective audit approved by the clinical audit lead. All patients aged >80 years who attended diabetes outpatient clinics 2 years prior to the date of the audit (April 2012) were identified from clinic records. A detailed history including demographics, comorbidities and treatment were collected. Blood pressure readings, HbA1c, cholesterol and renal function were extracted and the mean of these readings was recorded. Survival status at 2 years was recorded for all patients. Statistical analysis was performed using SPSS19.
Results: Data were available for 864 (381 male, 483 female) patients. The majority (75%) lived in their own home. More than 60% had multiple comorbidities and 25% had a prior history of cardiovascular disease. Two-thirds of the patients had more than one hospital admission in 2 years and a third had more than three admissions. 60% were on either insulin or a sulfonylurea. Mean HbA1c was 7.6%, cholesterol 4.2mmol/l, systolic blood pressure 145mmHg and eGFR 53ml/min. Over 2 years, 174 (20%)had died. Age, creatinine and previous coronary heart disease were significant predictors of death.
Conclusion: The benefits of intensive diabetes management appear to be uncertain in very elderly patients. The need for intensive treatment must therefore be individualised to each patient.
Original languageEnglish
Article numberP155
Pages (from-to)74
Number of pages1
JournalDiabetic Medicine
Volume31
Issue numbers1
Publication statusPublished - 31 Mar 2014
EventDiabetes UK Professional Conference 2014 - Arena and Convention Centre, Liverpool, United Kingdom
Duration: 5 Mar 20147 Mar 2014

Bibliographical note

Special Issue: Abstacts of the Diabetes UK Professional Conference 2014, Arena and Convention Centre, Liverpool, UK, 5–7 March 2014

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    • 3 Meeting abstract
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    Abernethy, G., Mann, V., John, R., Shakher, J., Bellary, S., Tahrani, A. A., Brown, A. C., Wright, A. & Davies, R., 31 Mar 2014, In : Diabetic Medicine. 31, s1, p. 7 1 p., A17 (P234).

    Research output: Contribution to journalConference abstract

  • Diabetes management in care homes: steps in the right direction?

    Sloan, E. & Bellary, S., 31 Mar 2014, In : Diabetic Medicine. 31, s1, p. 164 1 p., P455.

    Research output: Contribution to journalConference abstract

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