Endocrine Abstracts

Introduction: Diabetes in the elderly is a major public health problem in Tunisia. Its prevalence increases with aging population. The aim of this study was to determine the particularities of insulin-requiring diabetes in elderly patients in hospitals.

Methods: This was a retrospective cross study about insulin-treated diabetics admitted in our institute between August and October 2016 for uncontrolled diabetes. Was considered as elderly diabetic any patient of 60 years and older. Data about medical history, comorbidities and clinical examination were collected from medical file of patients.

Results: This study included 132 patients with insulin-requiring diabetes. Patients aged 60 and older accounted for 37.8% of cases (n=50). The mean age was 69 years (raging 60–84 years). Sex ratio(F/H) was 0.56. The mean number of years since diagnosis of diabetes was 17.6 years with extremes ranging from 3 months to 42 years. Insulin therapy was initiated for an average of 8 years. The incomplete basal bolus regimen was the most prescribed (40%). Only 16% of patients were on insulin analogues and half of them were over 75 years old. One third of the patients reported hypoglycaemia. None of them were under analogues. The significantly more frequent complications in elderly patients than in younger ones were: retinopathy (69% vs 45%, P=0.01), neuropathy (62% vs 44%, P=0.005) and nephropathy (58% vs 28%, P=0.01). One third of patients was treated for a coronary artery disease and 10% had cataracts. Dyslipidemia, arterial hypertension and obesity were observed in 80, 68 and 50% of elderly diabetics, respectively.

Conclusion: The typical profile of our elderly population was that an obese type 2 diabetic woman at high cardiovascular risk. The frequency of hypoglycaemia and the high prevalence of degenerative complications in our diabetic elderly population can lead to a loss of autonomy.