Comorbidities, geriatric syndromes, and glycaemic control among older patients with diabetes: a multi-centre study in Vietnam

AimThis study aimed to examine the burden of comorbidities and common geriatric syndromes in older adults with type 2 diabetes mellitus in Vietnam and their relationship with poor glycaemic control. MethodsThis is a cross-sectional study of patients aged 60 years or older diagnosed with type 2 diabetes who visited the cardio-metabolic clinics of two urban hospitals in Ho Chi Minh City, Vietnam, between November 2022 and June 2023. Poor glycaemic control was defined as HbA1c [≥] 7.0%. Comorbidity severity was assessed using the Charlson Comorbidity Index (CCI). Frailty was defined using Frieds criteria. Polypharmacy was defined as the use of five or more medications daily. Multiple-adjusted logistic regression models were applied to identify the factors associated with poor glycaemic control. ResultsThere were 576 participants. They had a mean age of 71.9 (SD 7.6) years, 46% were female, 30% were frail, 77% had polypharmacy. The mean duration of diabetes was 10.9 years (SD 7.4). The mean CCI was 2.5 (SD 1.1), and 34% of the participants had a CCI [≥]3. The most common comorbidities were dyslipidaemia (98%), hypertension (96%), followed by chronic kidney disease (17%), and peripheral artery disease (11%). The prevalence of poor glycaemic control (HbA1c [≥] 7%) was 47%. The factors significantly associated with poor glycaemic control were polypharmacy, frailty, and long duration of diabetes. ConclusionThere was a high prevalence of comorbidity, frailty, and polypharmacy among the participants; all were related to poor glycaemic control. Optimizing polypharmacy, frailty and comorbidity is essential in managing long-term diabetes.