The effect of frailty on post-discharge management and outcomes of acute glycaemic crises: Analysis of admissions for hypoglycaemia and hyperglycaemia in Australia.

Autor: Morton JI; Centre for Medicine Use and Safety, Monash University, Melbourne, Australia; Baker Heart and Diabetes Institute, Melbourne, Australia. Electronic address: jedidiah.morton@monash.edu., Ilomäki J; Centre for Medicine Use and Safety, Monash University, Melbourne, Australia., Wood SJ; Centre for Medicine Use and Safety, Monash University, Melbourne, Australia., Liau SJ; Centre for Medicine Use and Safety, Monash University, Melbourne, Australia., Steeper M; Centre for Medicine Use and Safety, Monash University, Melbourne, Australia., Doody H; Centre for Medicine Use and Safety, Monash University, Melbourne, Australia; Victorian Heart Hospital, Melbourne, Australia., Bell JS; Centre for Medicine Use and Safety, Monash University, Melbourne, Australia.
Jazyk: angličtina
Zdroj: Diabetes research and clinical practice [Diabetes Res Clin Pract] 2024 Mar; Vol. 209, pp. 111572. Date of Electronic Publication: 2024 Feb 09.
DOI: 10.1016/j.diabres.2024.111572
Abstrakt: Objective: To describe changes in glucose-lowering drug (GLD) dispensing by frailty status for people with diabetes following admission for hypoglycaemia or hyperglycaemia.
Methods: This study included all people with probable type 2 diabetes in the state of Victoria, Australia, admitted to hospital for hypoglycaemia (n = 2,506 admissions) or hyperglycaemia (n = 1,693) between 1 July 2013 and 29 June 2017. Frailty was defined via the Hospital Frailty Risk Score (HFRS). We examined differences in dispensing of GLDs in the year before and after admission using linear regression models adjusted for age, sex, comorbidities, and socioeconomic status.
Results: Dispensing of GLDs decreased following hypoglycaemia admission. Decreased dispensing was strongly associated with frailty status, with a change in mean annual GLD dispensing count of -4.11 (-5.05, -3.17) for an HFRS of 15 vs. -0.99 (-1.47, -0.50) for an HFRS of 0. Changes were greatest for metformin and sulfonylureas. Following hyperglycaemia admission, the mean number of annual GLD dispensings increased, with a smaller increase with increasing frailty: 2.44 (1.32, 3.56) for an HFRS of 0 vs. 1.16 (0.18, 2.14) for an HFRS of 15.
Conclusions: Frailty was associated with more conservative diabetes medication management following hypoglycaemia and hyperglycaemia admissions.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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