The goal of diabetes management in the elderly is often described as individualised and focusing on quality of life (1). There is a statistically significant association between blood glucose control and quality of life in adults with type 2 diabetes (2). However fewer studies have been performed on the elderly.
The purpose of this study is to further explore the relationship between insulin use and glycaemic control on quality of life in an elderly population.
Cross-sectional surveys were conducted for type 2 diabetic patients aged 75 or above. Diabetes-specific quality of life was assessed by the Problem Areas in Diabetes (PAID) scale and the Elderly Diabetes Burden Scale (EDBS). Information was obtained about participants’ age, gender, HbA1c and insulin use. Patients were excluded if they were non English speaking or had an Abbreviated Mental Test Score ≤ 7. Statistical analysis was done using the two sample t test and Pearson correlations.
The study is ongoing. Here we present preliminary results. Thirty one patients have participated in this study. The average age was 81. There was no significant association between HbA1c or insulin use and diabetes-specific quality of life, although both PAID and EDBS were numerically higher in insulin users. Insulin use was associated with a higher Hba1c compared to non-insulin dependent diabetics (HbA1c 7.9% and 6.7% respectively, p=0.02). Interestingly, patients living in residential accommodation had lower PAID scores than those living at home (PAID scores 2 and 13 respectively, p=0.008).
The management of diabetes in the elderly should be guided by quality of life. High HbA1c may not be associated with poor quality of life in the elderly. Treatment decisions for type 2 diabetes in the elderly should therefore be individualised.