Younger people with Type 2 diabetes have poorer self-care practices compared with older people: results from the Australian National Diabetes Audit

Diabet Med. 2018 Aug;35(8):1087-1095. doi: 10.1111/dme.13660. Epub 2018 Jun 1.

Abstract

Aim: This cross-sectional study compares the self-care practices of younger and older people with Type 2 diabetes.

Methods: Data were analysed from the Australian National Diabetes Audit (ANDA) including 2552 adults with Type 2 diabetes from Australian Diabetes Centres. Pre-specified demographic and clinical variables were obtained. Self-care variables (physical activity, following dietary recommendations, medication adherence and monitoring blood glucose levels) were compared in people ≤ 64 and > 64 years of age.

Results: Mean age (± sd) of participants was 63 ± 13 years overall, 53 ± 9 years for the younger group and 73 ± 6 years for the older group. A greater proportion of younger people had HbA1c levels > 53 mmol/mol (> 7.0%) (76% vs. 68%), reported difficulty following dietary recommendations (50% vs. 32%) and forgetting medications (37% vs. 22%) compared with older people (all P-values <0.001). A smaller proportion of younger compared with older people reported monitoring their blood glucose levels as often as recommended (60% vs. 70%, P < 0.001). Similar proportions of people aged ≤ 64 and > 64 years required insulin therapy (59% vs. 57%, P = 0.200). Younger age was associated with a twofold increase in the odds of not following the recommended self-care practices after adjustment for gender, smoking, insulin therapy, depression and allied health attendance (all P < 0.001).

Conclusions: Despite shorter diabetes duration, younger age was associated with worse glycaemic control and poorer diabetes self-care practices among people with Type 2 diabetes. Targeted strategies are required to optimize diabetes self-care practices and thereby glycaemic control.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Australia / epidemiology
  • Blood Glucose / analysis
  • Blood Glucose / metabolism
  • Blood Glucose Self-Monitoring / methods
  • Blood Glucose Self-Monitoring / statistics & numerical data
  • Clinical Audit
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / therapy*
  • Female
  • Glycated Hemoglobin / analysis
  • Glycated Hemoglobin / metabolism
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Self Care / standards
  • Self Care / statistics & numerical data*
  • Young Adult

Substances

  • Blood Glucose
  • Glycated Hemoglobin A