Objective : We performed a narrative analysis of the data of diabetes of elderly patients how the Japanese Clinical Practice Guidelines have worked on glycemic control.
Methods : We analyzed two sets of data, one from patients who visited initially during April and June in 2009, 2014 and 2019, respectively, and the other from 168 patients followed for 10 years successively, with analysis on Hb (hemoglobin) A1c and the number of hypoglycemic agents (prescriptions)/patient.
Results : In the first set, the patient numbers were 351, 487 and 572 in each year with a mean age of 68.5, 70.5 and 71.7 years, respectively. The mean HbA1c, 7.3~7.4%, was not significantly different from each year, but prescriptions/patient were greater in 2019 than in 2009, 1.7±1.3 (mean±SD) vs 1.2±1.1. Upon division into Groups 1 to 3 by age, <65 years, 65 to 74 years, and ≥75 years old, respectively, HbA1c was greater in Group 1 than in Groups 2 and 3, and so were prescriptions/patient, especially DPP-4i and SGLT-2i. In the second set, the mean HbA1c was greater with time and so were prescriptions/patient, 1.2±1.1 in 2009 vs 2.1±1.4 in 2019. Upon division into three groups (T1, T2 and T3) by age tertile, with a mean age of 55.7, 66.0, and 75.4 years in 2009, respectively, HbA1c was higher and the fraction of the patients having <7.0% HbA1c less in T1 than in T3. Prescriptions/patient were greater in T1 than in T3 all through the observation period.
Conclusion : Diabetes control has been at a reasonable level in the elderly patients (≥65 years) but not in the middle-aged.
抄録全体を表示