Quality of Diabetes Care Among Older Adults in Germany—Results of the Study on Health of Older People 2022/2023 Compared With Previous National Health Surveys
Yong Du, Giselle Sarganas, Beate Gaertner, Maike Buchmann, Judith Fuchs, Hannelore Neuhauser, Christin HeidemannABSTRACT
Aims
The study aims (1) to evaluate the quality of diabetes care considering guideline‐recommended medical therapies, cardiometabolic factors, and self‐management of health behaviours among older adults with diabetes in Germany, and (2) to examine time trends.
Materials and Methods
People aged 66 years and older with diabetes were identified from the examination part of the German national Study on Health of Older People (Gesundheit65+) in 2022/2023. Diabetes care indicators included physical exercise, non‐smoking, non‐obesity, blood pressure (BP) control, guideline‐based medication use for statins, ACEI/ARB, GLP‐1RA/SGLT2i, and aspirin. Temporal trends were examined in a subgroup aged 66–79 years using national health survey data from 1997 to 1999 and 2008 to 2010.
Results
Of 292 older adults with diabetes in Gesundheit65+, 90.6% were non‐smokers, 69.6% were non‐obese, 74.2% achieved BP control, and 45.5% engaged in physical exercise. Overall, 73.6% reported use of antidiabetics, with 24.3% treated by mono‐metformin therapy, 16.9% with insulin (alone or in combination), and 32.4% by other glucose‐lowering medication. Guideline‐recommended medication use was 65.7% for statins overall and 88.4% for ACEI/ARB among individuals with hypertension. Among individuals with cardiovascular disease, it was 36.8% for GLP‐1 RA/SGLT2i and 55.4% for aspirin. Trend analysis in 66‐ to 79‐year‐olds showed a decrease in insulin use and improvements regarding physical exercise, non‐obesity, BP control and guideline‐based medications.
Conclusions
In Germany, most older adults with diabetes meet targets of non‐smoking, non‐obesity and BP control. Use of novel glucose‐lowering medications with cardiorenal benefits is low. Despite improvements over time, guideline‐based medication use should be further improved.