A cohort study on the impact of health status stratification on poor prognosis in older adults with type 2 diabetes mellitus
ZONG Qianxing
TANG Wei
WU Haidi
LIU Dongmei
MO Yongzhen
Abstract：Objective To investigate the risk of adverse outcomes(hypoglycemia,hospitalization,death,and decline in quality of life)in older patients with type 2 diabetes mellitus(T2DM)based on health status stratification.Methods A prospective cohort study was conducted,enrolling 308 older T2DM patients from February 2022 to July 2022.According to the Chinese Guidelines for the Diagnosis and Treatment of Senile Diabetes(2021 edition),participants were stratified into good,intermediate,and poor health groups.Baseline data were collected,and prospective follow-up was performed.Kaplan-Meier survival analysis and Cox proportional hazards regression models were used to assess the association between health status stratification and adverse outcomes.Results Two hundred and seventy-seven patients completed a median follow-up of 6 months.Stratified by health status:101 cases(32.8%)in the good health group,164 cases(53.2%)in the moderate health group,and 43 cases(14.0%)in the poor health group.Significant differences were observed among the three groups in key baseline characteristics such as age,comorbidity count,cognitive function,and self-care ability(P<0.05).Multivariate Cox regression analysis showed that compared with the good health group,patients in the poor health group had significantly higher risks of hospitalization(HR=2.365,95%CI:1.078-5.193),hypoglycemia(HR=3.470,95%CI:1.430-8.419),and decline in quality of life(HR=2.082,95%CI:1.003-4.321).The risk of death in the poor health group also showed an increasing trend(HR=8.797,95%CI:0.655-118.073).Conclusions Health status stratification is an independent predictor of short-term adverse outcomes in older T2DM patients.Implementing a safety-oriented individualized management strategy for patients in poor health status may help improve their clinical outcomes.
Keywords：Type 2 diabetes mellitusAgedHealth status stratificationCohort studiesPersonalized Management
Publication Date：2026-01-20
Online Publishing Date：2026-01-29(First online date of this platform, not the publication date of the document)
Pages：8( 80-87 )