January 24, 2018 - In a recent Diabetes, Obesity & Metabolism analysis of individuals aged ≥70 years with type 2 diabetes, almost 40% with recommended HbA1c levels (which indicate blood glucose levels) were over-treated.
The majority of over-treated people were frail and used ≥5 medicines. Hypoglycemia occurred in 20.3% of these patients and almost 30% reported fall accidents. The investigators noted that clinicians should leave the ‘one size fits all’ approach and realize the possible benefits of de-intensifying blood glucose lowering treatment.
“In older patients with longstanding diabetes and a complex treatment regimen, the risk-benefit ratio of stringent blood glucose treatment is doubtful. Physicians, follow the guidelines and dare to de-intensify the blood glucose lowering medication in a shared decision with your older patient with diabetes,” said lead author Dr. Huberta Hart, of the University Medical Center Utrecht, in The Netherlands.
Full citation: Hart HE, Rutten GE, Bontje KN, Vos RC. Overtreatment of older patients with type 2 diabetes mellitus in primary care. Diabetes Obes Metab 2018; 1-4. https://doi.org/10.1111/dom.13174
Copyright © 2018 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd., reproduced with permission.
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