Comorbid Conditions and Glycemic Control in Elderly Patients with Type 2 Diabetes Mellitus, 1988 to 1994 to 1999 to 2004

Authors

  • Dong-Churl Suh MBA, PhD,

    1. From the *Ernest Mario School of Pharmacy, Rutgers University, Piscataway, New JerseyDepartment of Family Medicine, Catholic University College of Medicine, Seoul, KoreaNovartis Pharmaceuticals Corporation, East Hanover, New Jersey.
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  • Chul-Min Kim MD, PhD,

    1. From the *Ernest Mario School of Pharmacy, Rutgers University, Piscataway, New JerseyDepartment of Family Medicine, Catholic University College of Medicine, Seoul, KoreaNovartis Pharmaceuticals Corporation, East Hanover, New Jersey.
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  • In-Sun Choi PhD,

    1. From the *Ernest Mario School of Pharmacy, Rutgers University, Piscataway, New JerseyDepartment of Family Medicine, Catholic University College of Medicine, Seoul, KoreaNovartis Pharmaceuticals Corporation, East Hanover, New Jersey.
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  • Craig A. Plauschinat PharmD, MPH

    1. From the *Ernest Mario School of Pharmacy, Rutgers University, Piscataway, New JerseyDepartment of Family Medicine, Catholic University College of Medicine, Seoul, KoreaNovartis Pharmaceuticals Corporation, East Hanover, New Jersey.
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  • Portions of this study were presented at the Academy of Managed Care Pharmacy's Educational Meeting, October 5–8, 2005, Nashville, Tennessee, and at the American Geriatrics Society Annual Scientific Meeting, May 3–7, 2006, Chicago, Illinois. In addition, a portion of the data was published as an abstract in the proceedings of the 65th Scientific Sessions of the American Diabetes Association (Diabetes 2005;54(Suppl 1):A589).

Address correspondence to Dong-Churl Suh, MBA, PhD, Ernest Mario School of Pharmacy, Rutgers University, 160 Frelinghuysen Road, Piscataway, NJ 08854. E-mail: dsuh@rci.rutgers.edu

Abstract

OBJECTIVES: To compare the prevalence of type 2 diabetes mellitus in the U.S. elderly population between 1988 to 1994 and 1999 to 2004 and to assess glycemic control and comorbid conditions in this population.

DESIGN: Serial U.S. population-based cross-sectional surveys.

SETTING: National Health and Nutrition Examination Surveys (1988–1994 and 1999–2004).

PARTICIPANTS: Survey participants aged 65 and older with type 2 diabetes mellitus.

MEASUREMENTS: Glycemic control, measured as hemoglobin A1C (hA1C) less than 7%, prevalence of comorbid conditions, pharmacologic treatment rate, blood pressure, and serum cholesterol.

RESULTS: The prevalence of diagnosed type 2 diabetes mellitus in the U.S. elderly population increased from 12.0% to 14.1% (P=.004) between 1988 and 2004. Many patients had comorbid conditions; in 1999 to 2004, 36.7% had nephropathy, 31.5% renal insufficiency, 20.2% history of myocardial infarction, and 17.9% heart failure. The proportion of patients treated with antihyperglycemic medication increased from 75.1% in 1988 to 1994 to 85.6% in 1999 to 2004 (P<.001), and glycemic control rates also improved, from 44.7% to 54.8% (P<.001). Greater improvement in glycemic control rates was evident in patients without comorbidities (P<.001). Adjusted for patient characteristics, including duration of diabetes mellitus, patients with nephropathy or renal insufficiency were 40% less likely to achieve controlled hA1C as those without.

CONCLUSION: Despite improvements in the rates of treatment and glycemic control, approximately half of elderly patients diagnosed with type 2 diabetes mellitus have hA1C levels of 7% or higher. Many patients suffer from comorbid conditions, which may present a challenge for successful diabetes mellitus management.

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