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

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.