Quality of life, characteristics and metabolic control in diabetic geriatric patients

To describe the characteristics, metabolic control and health-related quality of life (HRQL) of type 2 diabetes mellitus (T2DM) geriatric patients.

Cross-sectional descriptive study of consecutive patients attended at a geriatric outpatient clinic in a tertiary hospital over three months. Sociodemographic, geriatric assessment variables, HRQL (using the EuroQol instrument) and comorbidity (Charlson and CIRS-G indexes) were measured. The presence of macrovascular and microvascular complications and cardiovascular risk factors were investigated. To assess the degree of metabolic control, the European Union Geriatric Medicine Society (EUGMS) criteria were followed with patients under 80 years old being considered as young elderly and disability as dependence on more than 2 ADLs or need of aid in ambulation.

We included 112 patients with an average age of 81.4±5.7 years, a Charlson comorbidity index of 4.3±1.57 and a CIRS-G index of 9.7±3. Seventy four per cent of patients were dependent on none or only one ADL, 38.5% presented cognitive impairment and 40% depression. Appropriate control of basal glucose and glycosylated haemoglobin was seen in 43.2% of the patients. HRQL indicated a high frequency of involvement with a significant relationship with functional dependence, cognitive impairment, and depression but not with metabolic control.

Geriatric patients with T2DM treated on an outpatient basis have a heavy load of comorbidity and an insufficient level of metabolic control even when individually adapted to age and functional state. HRQL is greatly impaired and related to their functional, cognitive and affective derangements.