韩国老年糖尿病患者:最新临床和流行病学趋势。

IF 6.8 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Kyuho Kim, Bongseong Kim, Kyuna Lee, Yu-Bae Ahn, Seung-Hyun Ko, Sung Hee Choi, Kyungdo Han, Jae-Seung Yun
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引用次数: 0

摘要

背景:老年人糖尿病正在成为韩国的一个重大公共负担。然而,对老年糖尿病患者的流行病学趋势和详细的临床特征缺乏全面的了解。因此,我们评估了韩国老年人糖尿病的流行病学趋势、代谢和生活方式特征。方法:分析韩国国民健康与营养调查数据,根据糖尿病病程和生活方式行为评估糖尿病患病率。此外,我们利用国民健康保险系统的国家健康信息数据库来评估身体活动水平、抗糖尿病药物使用、多种药物、药物依从性和主要合并症。结果:在过去十年中,老年人中新诊断的糖尿病病例的绝对数量翻了一番。与没有糖尿病的老年人相比,老年糖尿病患者的代谢指标管理率更高。达到最低推荐运动量的老年糖尿病患者比例逐年增加。与10年前相比,二肽基肽酶-4抑制剂或钠-葡萄糖共转运蛋白-2抑制剂的使用增加了,血脂异常、痴呆、癌症、心力衰竭、心房颤动和慢性肾病等合并症也增加了。在终末期肾病或痴呆、胰岛素使用、高风险酒精使用和独居者中,初始药物依从性显著降低。糖尿病诊断后1年继续使用胰岛素的患者在诊断时开始胰岛素治疗、有视网膜病变、服用三联抗糖尿病药物和有癌症史的患者中显著更高。结论:对老年糖尿病患者进行代谢指标和身体活动的综合管理是必要的。需要改进处方指南,对年龄相关合并症进行个性化管理,以及考虑老年糖尿病患者异质性的个性化方法。需要进一步的研究,如针对老年人的高质量队列和干预研究,以建立老年糖尿病患者的循证管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Older Adults with Diabetes in Korea: Latest Clinical and Epidemiologic Trends.

Backgruound: Diabetes in older adults is becoming a significant public burden to South Korea. However, a comprehensive understanding of epidemiologic trends and the detailed clinical characteristics of older adults with diabetes is lacking. Therefore, we evaluated epidemiologic trends and the metabolic and lifestyle characteristics of diabetes in Korean older adults.

Methods: We analyzed data from the Korea National Health and Nutrition Examination Survey to assess diabetes prevalence according to diabetes duration and lifestyle behaviors. In addition, we drew upon the National Health Information Database of the National Health Insurance System to assess physical activity levels, antidiabetic medication use, polypharmacy, medication adherence, and major comorbidities.

Results: The absolute number of newly diagnosed cases of diabetes among older adults doubled over the past decade. Management rates of metabolic indicators were higher in older adults with diabetes compared to those without diabetes. The proportion of older adults with diabetes meeting the minimum recommended physical activity increased over the years. Compared to 10 years before, the use of dipeptidyl peptidase-4 inhibitor or sodium-glucose cotransporter-2 inhibitor had increased, as had comorbidities such as dyslipidemia, dementia, cancer, heart failure, atrial fibrillation, and chronic kidney disease. Initial medication adherence was significantly lower in those with end-stage kidney disease or dementia, insulin use, high-risk alcohol use, and living alone. Continuing insulin use 1 year after diagnosis of diabetes was significantly higher in those who initiated insulin therapy at diagnosis, had retinopathy, were on triple antidiabetic medications, and had a history of cancer.

Conclusion: Comprehensive management of metabolic indicators and physical activity is essential for older adults with diabetes. Improvements in prescribing guidelines, personalized management of age-related comorbidities, and individualized approaches that consider the heterogeneous nature of older adults with diabetes are desirable. Further research, such as high-quality cohort and intervention studies specific to older adults, is needed to establish evidence-based management for older adults with diabetes.

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来源期刊
Diabetes & Metabolism Journal
Diabetes & Metabolism Journal Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
10.40
自引率
6.80%
发文量
92
审稿时长
52 weeks
期刊介绍: The aims of the Diabetes & Metabolism Journal are to contribute to the cure of and education about diabetes mellitus, and the advancement of diabetology through the sharing of scientific information on the latest developments in diabetology among members of the Korean Diabetes Association and other international societies. The Journal publishes articles on basic and clinical studies, focusing on areas such as metabolism, epidemiology, pathogenesis, complications, and treatments relevant to diabetes mellitus. It also publishes articles covering obesity and cardiovascular disease. Articles on translational research and timely issues including ubiquitous care or new technology in the management of diabetes and metabolic disorders are welcome. In addition, genome research, meta-analysis, and randomized controlled studies are welcome for publication. The editorial board invites articles from international research or clinical study groups. Publication is determined by the editors and peer reviewers, who are experts in their specific fields of diabetology.
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