A Retrospective Review of Anti-Diabetic Regimens in Geriatric Emirati Patients with Type 2 Diabetes and Its Relation to Glycemic Control: A Dubai Hospital Outpatient Clinic Experience

Abstract

Geriatric population is a special subset of adult population with different needs as there are physiological changes that occur with aging, that lead to a decline in patient’s overall performance functional disabilities and, cognitive impairment, We reviewed the various anti diabetic regimes in Emirati geriatric patients with type 2 diabetes following outpatient medical clinics. In a view to find optimum anti-diabetic regime which is more suitable and acceptable to the patients with minimum side effects. We believe that patients following in government hospitals would be a true representation of whole subset of Emirati geriatric population and hence any results obtained could be a reflection of entire Emirati geriatric population. Medical records of 350 Emirati type 2 diabetic patients age above 65 were reviewed. HBAIC at the clinic visit was noted and they were retrospectively followed up as to see which anti diabetic regime these patients were on for the preceding 3 months. Patients were divided accordingly into 4 groups namely. a) Those on oral hypoglycemic, b) oral hypoglycemic plus basal insulin, c) premix insulin and d) basal insulin bolus. Mean HBAIC was compared amongst the various age groups. Conclusion 350 patients were following medical clinics, 16 patients were excluded. Out of the remaining 334 patients 224 were females and 110 were males. Patients were divided into 2 groups according to age. Patients less than 70 years of age were 121 (36.2%) and patients greater than 70 years of age were 213 (63.8%). Patients in both these age groups had uncontrolled blood sugars. HBAIC 8.1% vs. HBAIC 7.76% in patients less than 70 year’s vs. patients greater than 70 years age). In higher age groups HBAIC was better controlled as compared to lesser age groups reflecting better care of elderly in the Emirati society. Most patients were on oral hypoglycemic as compared to insulin (60.5% vs. 21.6%). Both males and females were better controlled on oral medication as compared to insulin (HBAIC 7.58% males and HBAIC 7.69% in females on oral medications). Sulfonyl urea and metformin being the most popular oral medications used. Only 21.6% were on insulin reflecting increase needle phobia in the elderly age groups.