Evaluation of survival in the elderly with diabetes mellitus according to the Clinical Practice Guide

Abstract

Objective: to evaluate survival rate in older adults diagnosed with type 2 diabetes mellitus (t2dm) according to Mexico’s Clinical Practice Guidelines (cpg) for the diagnosis and treatment of t2dm in vulnerable older adults. Methods: A cross-sectional study was carried out, collecting the electronic records of participants matriculated in Family Medicine Unit No. 80 of the Mexican Institute of Social Security in Morelia, Michoacan, Mexico. Electronic files of participants older than 65 years old and diagnosed with t2dm were included. The cpg was used to identify vulnerability, geriatric syndromes, participants complications, as well as t2dm diagnosis and treatment. The Kolmogorov-Smirnov test was applied to evaluate data distribution; Student’s t test for independent samples, and Kaplan Meier with Log Rank were assessed to compare survival curves. Statistical significance was established with p<0.05. Results: 41 vulnerable older adults (28.47%) and 103 non-vulnerable older adults (71.52%) were analyzed; 90.2% of the vulnerable adults presented polypharmacy and 73.2%, cognitive impairment. Nephropathy was the most frequent complication (p<0.0001). Survival curves showed that vulnerable adults die before than non-vulnerable adults [Log Rank: 4.180; p=0.041]. Conclusions: vulnerable older adults have lower survival rate than non-vulnerable ones, and this result is influenced by metabolic control, cognitive impairment, polypharmacy, and depression.