Trends in Diabetes Medication Use and Prevalence of Geriatric Syndromes in Older Mexican Americans from 1993/1994 to 2004/2005

Abstract

Background: New diabetes medications introduced over the last decade have fed to changes in diabetes treatment recommendations for the increasing number of elderly patients with diabetes. It is, however, not clear whether these changes are accompanied by changes in prevalence of comorbid geriatric syndromes. Objective: To determine whether changes in diabetes treatment between 1993/1994 and 2004/2005 were accompanied by changes in prevalence of geriatric syndromes in Mexican Americans aged 75 years and older. Methods: Data from the Hispanic Established Population for the Epidemiologic Study of the Elderly were used. Participants aged 75 years and older with diabetes in 1993/1994 (n = 264) and in 2004/2005 (n = 324; new cohort added in 2004/2005) were included in the analyses. Medication use and geriatric syndromes prevalence rates were estimated and compared using descriptive and univariate statistics for continuous variables and contingency tables (χ2) for categorical variables. Results: Older Mexican Americans with diabetes in 2004/2005 were more likely to be taking 2 or more oral diabetes medications than were those in the 1993/1994 cohort; most of the drugs taken by the 2004/2005 cohort were the newly introduced oral diabetes medications. Use of insulin as sole diabetes therapy decreased from 20.3% in the 1993/1994 cohort to 7.5% in the 2004/2005 cohort. The 2004/2005 cohort reported longer diabetes duration and higher prevalence of obesity and hypertension; they were also more likely than the 1993/1994 cohort to have more geriatric syndromes: pain, arthritis, incontinence, and self-reported activities of daily living disability. No significant differences exist between the 2 cohorts in objective measures of cognitive and physical function. Conclusions: Older Mexican Americans with diabetes in 2004/2005 used more of the newer diabetes medications and less insulin compared to the 1993/1994 cohort. The prevalence rates of geriatric syndromes were higher in the 2004/2005 cohort. Our findings suggest that screening for and treating comorbid geriatric syndromes is increasingly important for optimal geriatric diabetes care.