Older people with Type 2 diabetes, including those with chronic kidney disease or dementia, are commonly overtreated with sulfonylurea or insulin therapies

Diabetic Medicine : a Journal of the British Diabetic Association
C E HamblingK Khunti

Abstract

To evaluate potential overtreatment with sulfonylurea and insulin therapies amongst older people with Type 2 diabetes, including those with chronic kidney disease or dementia. Using the ECLIPSE Live software tool, we developed a search to examine data on older people (age ≥ 70 years) with Type 2 diabetes, who were prescribed sulfonylurea or insulin therapies over the previous 90 days. Sixteen Norfolk general practices participated, representing a population of 24 661 older people, including 3862 (15.7%) with Type 2 diabetes. Of these, 1379 (35.7%) people were prescribed sulfonylurea or insulin therapies. Data extracted included age, sex, last recorded HbA1c value, renal function and dementia codes. The median age of the study cohort was 78 years. A total of 644 people (47.8%) had chronic kidney disease (estimated GFR < 60 mL/min/1.73m2 ) and 60 people (4.35%) had dementia. The median (interquartile range) HbA1c concentration for the entire cohort was 58 (51-69) mmol/mol [7.5 (6.8-8.5)%], with no difference in median HbA1c between those with or without either chronic kidney disease or dementia. In total, 400 older people (29.9%) had an HbA1c concentration < 53 mmol/mol (7%), of whom 162 (12.1%) had HbA1c < 48 mmol/mol (6.5%). St...Continue Reading

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Citations

Aug 31, 2020·British Journal of Clinical Pharmacology·Katharina Mattishent, Yoon Kong Loke
Aug 18, 2017·Diabetic Medicine : a Journal of the British Diabetic Association·R I G Holt
Jan 17, 2019·Current Diabetes Reviews·Omar Yaxmehen Bello-ChavollaCarlos Alberto Aguilar-Salinas
Feb 17, 2019·Current Diabetes Reports·Kristin K ClemensJinnie J Rhee
Feb 26, 2019·Therapeutic Advances in Endocrinology and Metabolism·Ketan Dhatariya
Jan 8, 2021·Pilot and Feasibility Studies·Annette Bævre LarsenMarit Graue
Jan 9, 2021·BMC Geriatrics·Monica HermannMarit Graue
May 19, 2021·Journal of the American Medical Directors Association·Jacquelina StasinopoulosJanet K Sluggett
Sep 14, 2021·International Journal of Clinical Practice·Labib Al-MusaweAna Paula Martins
Nov 3, 2020·Clinical Diabetes : a Publication of the American Diabetes Association·Robert A GabbayKamlesh Khunti

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