4CPS-021 Analysis of glycaemic control in elderly type 2 diabetic patients institutionalised in socio-healthcare centres

<h3>Background and Importance</h3> Diabetes affects between 25–33% of the elderly, with higher prevalence in those &gt;65 who have greater risk for complications significantly impacting their quality of life. <h3>Aim and Objectives</h3> Evaluate the control of type 2 diabetes mellitus(DM2) in patients institutionalised in socio-healthcare centres (SHC) through haemoglobin A1c (HbA1c) values adjusted for frailty criteria. <h3>Material and Methods</h3> Retrospective multicentre observational study conducted from January-March-2024. Elderly patients(&gt;65 years) with a diagnosis of DM2 institutionalised in 3 SHCs were included. The following variables were collected from the electronic medical records: <h3>Demographic</h3> Age, gender <h3>Clinical</h3> The latest HbA1c value(2023–2024 period). Frailty: Patients were stratified according to the criteria established by the American Diabetes Association(ADA) and the geriatric assessment, differentiating: Healthy patient &gt;65 years:0–1 chronic diseases, intact functional/cognitive status, life expectancy&gt;10 years. HbA1c:7–7.5%. Pre-frail patient:2–3 chronic diseases, mild functional/cognitive impairment(Barthel ≥60 or Katz C-D). HbA1c:7.5–8%. Frail patient:≥3 comorbidities, severe functional/cognitive impairment(Barthel 40–35, Katz E-F).HbA1c:8–8.5%. Dependent/end of life patient: Katz G,Barthel ≤35, immobile, and dependent. Do not measure HbA1c. Based on these criteria, it was assessed whether the latest HbA1c value was adjusted according to frailty. <h3>Results</h3> Out of a total of 512 patients institutionalised in 3different SHCs, 124 DM2 patients (24%) were selected, with a mean age of 84±7 years, 64% women. HbA1c data were not determined in 15% of the patients (19), the value was between 0–7% in 43% (53), between 7–7.5% in 16% (20), between 7.5–8% in 5% (6), between 8–8.5% in 7% (9), and above 8.5% in 14% (17) of the total patients. Regarding the frailty assessment, 20% (25) were considered healthy elderly, 36% (45) pre-frail, 25% (31) frail, 17% (21) dependent, and frailty data were not available for 2% (2). Concerning the previously established objectives regarding the adjustment of HbA1c based on frailty, it was determined that HbA1c was adjusted in 11% (14) of the cases, not adjusted in 56% (69), it was deemed unnecessary to measure HbA1c in 15% (18) due to the patient’s dependency or terminal status, and no recent HbA1c data were available in 19% (23) of the cases. <h3>Conclusion and Relevance</h3> In most cases in the study, glycaemic control by HbA1c was not adjusted according to frailty, and in 43%of cases, it was below the appropriate range for healthy elderly patients. The presence of a pharmacist in SHCs would be advisable to optimise the use of antidiabetic medications. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest