Aim: China has the largest diabetes population in the world at 114.4 million in 2017. However, data on the overall characteristics of older T2DM patients in China is limited. We aimed to investigate blood glucose control, potential factors associated with glucose control, albuminuria incidence, treatment patterns and hypoglycemia prevalence in Chinese T2DM patients, aged over 60 years.
Method: This nationwide cross-sectional study collected data from T2DM outpatients in 18 hospitals in China between March and December 2017. Descriptive analyses and logistic regression were performed to summarize data and identify potential associations, respectively.
Results: Our study included 1520 patients (mean age: 67.7± 5.86 years). Overall, 43.4% (660/1520) of patients had well controlled blood glucose (defined as HbA1c <7%). Older age, albuminuria and longer duration of diabetes were associated with decreased HbA1c control. Albuminuria was reported in 34.7% of patients (27.6% with micro-albuminuria and 7.1% with macro-albuminuria). The most commonly-used OADs were biguanide (42.6%), α-glucosidase inhibitors (AGI [33.5%]) and sulfonylureas (SU [22%]) and the most common dual OAD-combinations were biguanide combined with SU, biguanide combined with AGI, and AGI combined with SU. Additionally, 43.8% of patients received insulin. Only 4.7% of patients received DPP-4 inhibitors; no patient received SGLT2 inhibitors. The proportion of patients who reported a history of hypoglycemia was 28.0%.
Conclusion: In this cross-sectional study of older Chinese T2DM patients, fewer than half had an HbA1c of <7%. Around one third of patients had albuminuria, which was associated with a lower rate of HbA1c control. Given the relatively high risk of hypoglycemia in this population, increased use of OADs with low risk of hypoglycemia, such as DPP-4 inhibitors and SGLT2 inhibitors, should be considered.
J. Shen: None. M. Liu: None. B. Ye: None. Q. Li: None. D. Clark: None. L. Ji: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck KGaA, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Roche Pharma, Sanofi.
Boehringer Ingelheim; Eli Lilly and Company