Diabetes control in Swedish community dwelling elderly: more often tight than poor

OBJECTIVE: To determine glycaemic control in elderly patients with diabetes living in community dwelling. DESIGN: Descriptive, cross-sectional and open. Prospective with regard to blood glucose. SETTING: Community-dwelling in-patients. SUBJECTS: From a total number of 351 patients in seven Swedish centres of community dwelling we identified and recruited all 45 patients with diabetes receiving treatment with insulin, and/or oral medication. MAIN OUTCOME MEASURES: Blood glucose was measured fasting, 2 h after breakfast, in the evening and at night, for three consecutive days. RESULTS: Mean HbA1c was 5.9 +/- 1.1% (range 3.6-8.6%). The patients were split in three HbA1c-groups for analysis: lower- (3.6-5.3%), middle- (5.4-6.3%) and higher-tertile (6.4-8.6%). The groups where similar with regard to age, time in community dwelling, ability to eat and move around independently, but body mass index was lower in the lower tertile (P < 0.003 and P < 0.04, compared with middle- and higher-tertiles). We recorded 14 episodes with blood glucose </=4.0 mmol L-1 in eight patients. Blood glucose </=4.0 mmol L-1 was mostly recorded during night (n = 8) or in the morning (n = 3). CONCLUSIONS: Swedish patients with diabetes in community dwelling are over- rather than under-treated and have low HbA1c levels. Despite very regular eating habits and near total compliance with medication, hypoglycaemias are frequent and possibly linked to malnutrition.