Younger Patients with Type 2 Diabetes Have Poorer Self-Care Practices Compared with Older Patients—Results from the Australian National Diabetes Audit

Introduction: Type 2 diabetes is increasingly diagnosed among younger people. Patient engagement with self-care practices is crucial for the optimal management of type 2 diabetes. This study examines the self-care practices of younger and older patients with type 2 diabetes.

Methods: Data were analysed from the Australian National Diabetes Audit (ANDA) that included 2552 adult patients with type 2 diabetes from 56 participating Diabetes Centres. Pre-specified demographic and clinical variables were obtained. Self-care variables (physical activity, following dietary recommendations, medication adherence and monitoring blood glucose levels) were compared in patients ≤64 years and >64 years of age.

Results: Mean age (±SD) of participants was 63±13 years overall, 53±9 years for the younger group and 73±6 years for the older group. Mean diabetes duration was 9±8 years and 15±10 years for younger and older patients, respectively (p<0.01). A greater proportion of younger patients had HbA1c levels above 7.0% compared with older patients (76% vs. 68%, p<0.001). A greater proportion of younger compared to older patients reported difficulty following dietary recommendations (50% vs. 32%) and forgetting medications (37% vs. 22%) (all p values <0.001). A smaller proportion of younger compared with older patients reported monitoring their blood glucose levels as often as recommended (60%vs. 70%, p<0.001). Younger age was associated with a 2-fold increase in the odds of not following the recommended self-care practices after adjustment for gender, smoking, insulin therapy, depression and allied health attendance (all p values <0.001).

Conclusion: Despite shorter diabetes duration, younger age was associated with worse glycaemic control and poorer diabetes self-care practices among patients with type 2 diabetes. Targeted strategies are urgently required to optimise diabetes self-care practices and thereby improve glycaemic control.