Endocrine Abstracts

Introduction: Elderly diabetics are often fragile patients at high cardiovascular risk. The medical, human and socio-economic impact of diabetes is heavy in the elderly. Symptoms in this particular population are often insidious and atypical, which can delay diagnosis and the establishment of effective treatment. Indeed, management is not always easy because it must take into account multiple parameters. The objective of our study was to study the observance and particularities of treatment in elderly diabetics.

Methods: We conducted a retrospective observational study at the National Institute of Nutrition and Food Technology in Tunis, over a period from January 2018 to September 2021. Data were collected from patients’ medical observation records. We prepared an information sheet which was used for the statistical analysis of the data.

Results: We collected 35 elderly diabetic patients. The age of the patients varied from 70 to 89 years with an average age of 76.2 ± 4.5 years. Our population was characterized by a female predominance (66%). The average duration of diabetes in our population was 5.89 ± 3.91 years with extremes ranging from 1 to 14 years. The average age of discovery was 70.29 ± 4.44 years with extremes ranging from 65 to 79 years. All of our patients were type 2 diabetics. Glycated hemoglobin varied between 6.5% and 13.9% with an average of 8.9 ± 1.9%. More than half of the population had an HbA1c greater than 8.5%. About half of the study population were on oral antidiabetics alone. Insulin therapy was prescribed in 54% of the population, of which only two patients were on insulin analogues. For patients on insulin therapy, the most prescribed therapeutic regimen in our population was the basal regimen (56%) with an average daily dose of basal insulin in the order of 0.47 ± 0.25 U/Kg/d. Therapeutic non-compliance was mentioned in 54% of patients. The main reasons for stopping treatment were the unavailability of drugs at local dispensaries (26%) and adverse effects (21%) dominated by digestive disorders due to metformin.

Conclusions: Diabetes in the elderly remains an area to be discovered. Few studies have been carried out to date. The field therefore remains open to many studies, especially in terms of therapy.