medigraphic.com
ISSN 1405-8871 (Print)

2022, Number 3

<< Back Next >>

Aten Fam 2022; 29 (3)

Evaluation of survival in the elderly with diabetes mellitus according to the Clinical Practice Guide

Álvarez-Torres M, Álvarez-Aguilar C, Gómez-García A

Language: Spanish
References: 19
Page: 154-159
PDF size: 184.30 Kb.


ABSTRACT

Objective: to evaluate survival rate in older adults diagnosed with type 2 diabetes mellitus (T2DM) according to Mexico’s Clinical Practice Guidelines (CPG) for the diagnosis and treatment of T2DM in vulnerable older adults. Methods: A cross-sectional study was carried out, collecting the electronic records of participants matriculated in Family Medicine Unit No. 80 of the Mexican Institute of Social Security in Morelia, Michoacan, Mexico. Electronic files of participants older than 65 years old and diagnosed with T2DM were included. The cpg was used to identify vulnerability, geriatric syndromes, participants complications, as well as T2DM diagnosis and treatment. The Kolmogorov-Smirnov test was applied to evaluate data distribution; Student’s T test for independent samples, and Kaplan Meier with Log Rank were assessed to compare survival curves. Statistical significance was established with p‹0.05. Results: 41 vulnerable older adults (28.47%) and 103 nonvulnerable older adults (71.52%) were analyzed; 90.2% of the vulnerable adults presented polypharmacy and 73.2%, cognitive impairment. Nephropathy was the most frequent complication (p‹0.0001). Survival curves showed that vulnerable adults die before than non-vulnerable adults [Log Rank: 4.180; p=0.041]. Conclusions: vulnerable older adults have lower survival rate than non-vulnerable ones, and this result is influenced by metabolic control, cognitive impairment, polypharmacy, and depression.


REFERENCES

  1. Petersmann A, Müller-Wieland D, Müller UA,Landgraf R, Nauck M, Freckmann G, et al.Definition, Classification and Diagnosis of DiabetesMellitus. Exp Clin Endocrinol Diabetes. 2019;127(S01):S1-S7. DOI: 10.1055/a-1018-9078

  2. Basto-Abreu A, Barrientos-Gutiérrez T, Rojas-Martínez R, Aguilar-Salinas CA, López-OlmedoN, De la Cruz-Góngora V, et al. Prevalencia dediabetes y descontrol glucémico en México: resultadosde la Ensanut 2016. Salud Pública Mex.2020;62(1):50-59. DOI: 10.21149/10752

  3. Gopalraj R. The Older Adult with Diabetes andThe Busy Clinicians. Prim Care. 2017;44(3):469-

  4. DOI: 10.1016/j.pop.2017.04.0114. Jin X, Liu Y, Hu Z, Du W. Vulnerable OlderAdults’ Identification, Geographic Distribution,and Policy Implications in China. Int J EnvironRes Public Health. 2021;18(20):10642. DOI:10.3390/ijerph182010642

  5. Diagnóstico y tratamiento de diabetes mellitusen el adulto mayor vulnerable. Catálogo Maestro[Internet]. [Citado 2022 Mar 10]. Disponible en:https://cenetec-difusion.com/gpc-sns/?p=744

  6. Kim J, Miller S. Geriatric Syndromes: Meetinga Growing Challenge. Nurs Clin NorthAm. 2017;52(3):ix-x. DOI: 10.1016/j.cnur.2017.06.001

  7. Papatheodorou K, Banach M, Bekiari E, Rizzo M,Edmonds M. Complications of Diabetes 2017.Journal of Diabetes Research. 2018;2018:3086167.DOI: 10.1155/2018/3086167

  8. Guerrero-Godínez JM, Barragán-Vigil AM, Navarro-Macias CL, Murillo-Bonilla LM, Uribe-GonzálezRP, Sánchez-Cruz MA. Diabetes mellitus enel adulto mayor. Rev Med Clin. 2017;1(2):81-94.DOI: 10.5281/zenodo.1186879

  9. Adu-Sarkodie NY. Clinical Management of DiabetesMellitus in the Older Adult Patient. CurrDiabetes Rev. 2017;13(3):225-238. DOI: 10.2174/1573399812666161206151706

  10. American Diabetes Association Professional PracticeCommittee. 13. Older Adults: Standards ofMedical Care in Diabetes 2022. Diabetes Care.2022;45(Suppl.1):S195-S207. DOI:10.2337/dc22-S013

  11. Galván Ojeda I, Álvarez Aguilar C, Gómez GarcíaA. Control metabólico en adultos mayores con diabetesmellitus tipo 2 vulnerables y no vulnerables.Aten Fam. 2019;26(3):95-99. DOI:10.22201/facmed.14058871p.2019.3.70035

  12. Romero-Medina JL, González-López AM, Vázquez-Cruz E, Gutierrez-Gabriel I, Montiel-JarquínÁ, Córdova-Soriano JA, et al. Síndromes Geriátricosen pacientes de primer nivel de atención médica.Prensa Méd Argent. 2014;28(5):287-290.

  13. Becerra-Partida EN, Medina-Millan R, Riquer-Arias DR. Depresión en pacientes condiabetes mellitus tipo 2. Rev CONAMED.2019;24(4):174-178.

  14. Petersen RC, Lopez O, Armstrong MJ, GetchiusTSD, Ganguli M, Gloss D, et al. Practice guidelineupdate summary: Mild cognitive impairment:Report of the Guideline Development,Dissemination, and Implementation Subcommitteeof the American Academy of Neurology.Neurology. 2018;90(3):126-135. DOI:10.1212/WNL.0000000000004826

  15. Rawlings AM, Sharrett AR, Schneider AL, CoreshJ, Albert M, Couper D, et al. Diabetes in midlifeand cognitive change over 20 years: a cohortstudy. Ann Intern Med. 2014;161:785-793. DOI:10.7326/M14-0737

  16. Papunen S, Mustakallio-Könönen A, AuvinenJ, Timonen M, Keinänen- KiukaanniemiS, Sebert S. The association between diabetesand cognitive changes during aging. Scand JPrim Health Care. 2020;38(3):281-290. DOI:10.1080/02813432.2020.1802140

  17. Forbes A. Reducing the Burden of Mortalityin Older People With Diabetes: A Reviewof Current Research. Front Endocrinol (Lausanne).2020;17(11):133. DOI: 10.3389/fendo.2020.00133

  18. Tang O, Matsushita K, Coresh J, Sharrett AR,McEvoy JW, Windham BG, et al. Mortality Implicationsof Prediabetes and Diabetes in OlderAdults. Diabetes Care. 2020;43(2):382-388. DOI:10.2337/dc19-1221

  19. Alegre-Díaz J, Herrington W, López-Cervantes M,Gnatiuc L, Ramirez R, Hill M, et al. Diabetes andCause-Specific Mortality in Mexico City. N EnglJ Med. 2016;375(20):1961-1971. DOI: 10.1056/NEJMoa1605368




2020     |     www.medigraphic.com