Age-related differences in diabetes care outcomes in Korea: a retrospective cohort study

BMC Geriatrics

Research Article

Namhoon Kim¹  Baegju Na²  Myung Ki³  Sujin Baek⁴  Young-duk Yun⁴  Martin Hyde⁵ 

[1] Department of Internal Medicine, College of Medicine, Korea University, Seoul, South Korea;Department of Preventive Medicine, College of Medicine, Konyang University, Konyang Univ. Gwanjeo Campus, Gasuwon-dong, 302-833, Seo-gu, Daejeon, South Korea;Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, South Korea;Institute for Health Insurance Policy Research, National Health Insurance Service, Seoul, South Korea;Stress Research Institute, Stockholm University, Stockholm, Sweden;

关键词: Type 2 diabetes;    Diabetes management among older patients;    Hospitalization;    Glycemic control;    Risk factors;   

DOI  :  10.1186/1471-2318-14-111

 received in 2014-04-30, accepted in 2014-09-29,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundAge-related differences in diabetes outcomes are important both for clinical and policy considerations. To clarify the basis of such differences, we investigated patterns of associations for age in relation to hospitalization and glycemic control and examined the role of other factors.Methods4471 patients with diabetes aged 40–79 years were drawn from a retrospectively retrieved National Health Insurance Cohort. Using logistic regression, risk factors measured over the two years (2007–2008) were examined for their associations with hospitalization and poor glycemic control during the last year (2009) of follow-up.ResultsCompared to the middle-aged patients, older patients were more likely to have been hospitalized (Adjusted odds ratio (ORadjusted) = 1.97(95% CI = 1.28, 3.04) for the oldest group (ages 70–79) vs youngest group (ages 40–49)) but less likely to have poor glycemic control (ORadjusted = 0.45 (95% CI = 0.37, 0.56) for the oldest group vs youngest group). Older patients were also less likely to be obese but had more complications, longer duration of diabetes, lower continuity of care, and higher blood pressure and total cholesterol level. The pattern of associations for hospitalization and glycemic control was not uniform across the risk factors, sharing only a few common factors such as the duration of diabetes and blood pressure. In general, poor glycemic control was affected predominantly by metabolic management, while hospitalization was strongly related to functional status (i.e., number of complications) and care quality measures (i.e., continuity of care).ConclusionHospitalization was higher among the older diabetic patients, despite better glycemic control. Factors were differently associated with the two diabetes-related outcomes, providing more comprehensive risk profiles for hospitalization. The co-existence of improved glycemic control and increased hospitalization among older diabetic patients suggests an extension of a geriatric evaluation to wider functional and comorbidity status.

【 授权许可】

Unknown   
© Ki et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.