1.Anti-diabetic medication burden amongst older persons with diabetes and associated quality of life
Mohd Shaiful Ehsan Bin Shalihin ; Abdullah Bin Fauzi ; Nurul Afiqah binti Zulkifli ; Azrul Aziz bin Abdul Azi
The Medical Journal of Malaysia 2020;75(5):525-530
Background: Older persons with diabetes are the major
demographic of diabetic patients followed up in primary
health clinics. Despite their increasing age and morbidities,
they are still being managed strictly towards good sugar
control in order to achieve the ideal HbA1c level without
taking their quality of life into consideration. This study
aimed to determine the prevalence in the use of antidiabetic
drugs among older persons with diabetes and its
association with their quality of life.
Methodology: A cross-sectional study was conducted
among 269 older persons with diabetes in all government
health clinics in Kuantan using Diabetes Quality of Life
questionnaire. SPSS version 23 was used for the statistical
analysis.
Results: Majority of the respondents were females (61%),
Malays (84.8%), pensioners (54.3%) with education up to
primary school (52%) and are staying with family members
(93.7%). Most of the patients were on two antidiabetic agents
(48%) followed by a single antidiabetic agent (32%). Despite
the risk of hypoglycaemia, 0.4% of them are on
glibenclamide. The use of insulin is still common among
21% of them that are on intermediate-acting insulin, 15.6%
on premixed insulin and 7.8% on short-acting insulin. Those
taking a higher number of antidiabetic agents were found to
be associated with poorer quality of life (p=0.001) compared
to those taking one or two antidiabetic medications. Those
on insulin also have significantly poorer quality of life score
(p=0.012).
Conclusion: Despite aiming for controlled diabetes, older
persons suffer poor quality of life with further intensification
of their antidiabetic medications according to the guidelines.
This includes the complexity of insulin usage and
polypharmacy, which contribute to the low quality of life
score.