Long-term multiple risk factor interventions in Japanese elderly diabetic patients: The Japanese Elderly Diabetes Intervention Trial – study design, baseline characteristics and effects of intervention

Authors


  • Present addresses: Koichi Yokono, Department of General Medicine, Graduate School of Medicine, University of Kobe, Kobe; Junya Ako, Department of Cardiology, Jichi Medical University Saitama Medical Center, Oomiya, Saitama; Kouichi Kozaki, Department of Geriatric Medicine, Faculty of Medicine, Kyorin University, Mitaka, Tokyo; Tadasumi Nakano, Mitsubishi Kyoto Hospital, Kyoto.

Dr Atsushi Araki MD PhD, Department of Diabetes Mellitus, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan. Email: aaraki@tmghig.jp

Abstract

Aim:  To evaluate long-term, multiple risk factor intervention on physical, psychological and mental prognosis, and development of complications and cardiovascular disease in elderly type 2 diabetes patients.

Methods:  Our randomized, controlled, multicenter, prospective intervention trial included 1173 elderly type 2 diabetes patients who were enrolled from 39 Japanese institutions and randomized to an intensive or conservative treatment group. Glycemic control, dyslipidemia, hypertension, obesity, diabetic complications and atherosclerotic disease were measured annually. Instrumental activity of daily living, cognitive impairment, depressive symptoms and diabetes burden were assessed at baseline and 3 years.

Results:  There was no significant difference in clinical or cognitive parameters at baseline between the two groups. The prevalence of low activities of daily living, depressive symptoms and cognitive impairment was 13%, 28% and 4%, respectively, and was similar in the two groups. A small, but significant difference in HbA1c between the two groups was observed at 1 year after the start of intervention (7.9% vs 8.1%, P < 0.05), although this significant difference was not observed after the second year. With the exception of coronary revascularization, there was no significant difference in fatal or non-fatal events between the two groups. Composite events were also similar in the two groups.

Conclusions:  This study showed no significant differences in fatal or non-fatal events between intensive and conventional treatment. The present study might clarify whether treatment of risk factors influences function and quality of life in elderly diabetic patients. Geriatr Gerontol Int 2012; 12 (Suppl. 1): 7–17.

Ancillary