Objective  To explore the correlation between glycemic control and complexity of drug treatment regimens in elderly patients with type 2 diabetes mellitus.

Methods  A retrospective, cross-sectional study was conducted to collect the elderly patients with type 2 diabetes mellitus who were hospitalized in the Department of Endocrinology at the Geriatric Hospital of Nanjing Medical University from June 2022 to December 2024. The clinical characteristics and medication compliance of the patients were recorded through pharmaceutical consultations. The medication regimen complexity index (MRCI) and diabetes-specific medication regimen complexity index (D-MRCI) were calculated for each patient. Patients were divided into the target-achieving group and the non-target-achieving group based on whether their blood glucose met the criteria. Univariate analysis and multivariate Logistic regression analysis were used to identify the factors associated with adequate blood glucose control.

Results  A total of 152 patients were included, 123 (80.9%) had poorer glycemic control, 31.6% exhibited good medication adherence, and 76.3% demonstrated good adherence to diabetes medications. The mean total MRCI score was (25.90±8.63), while the median D-MRCI score was 9.00 (5.25, 11.75), with 44.7% of patients classified as having high D-MRCI scores (D-MRCI>9). The results of Spearman correlation analysis indicated that the number of medications used by patients was highly correlated with the MRCI score (r=0.899, P<0.001), while the number of diabetes medications used was highly correlated with the D-MRCI score (r=  0.705, P<0.001). Univariate analysis results revealed that high complexity diabetes medication regimen, duration of diabetes, the number of types of antidiabetic drugs, and the number of injectable antidiabetic medications were associated with glycemic control (P≤0.05). Multivariate analysis results showed that, high diabetes medication complexity was an independent risk factor for inadequate blood glucose control [OR=4.119, 95%CI (1.121, 15.139), P=0.033].

Conclusion  Higher D-MRCI (>9) was associated with poorer glycemic control. Simplifying medication regimens and optimizing medication management strategies may improve patient outcomes.

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