A Retrospective Time Trend Study Of Diabetes Overtreatment In Geriatric Patients
| Autor: | Zyta Beata Wojszel, Agnieszka Kasiukiewicz |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Pharmacology
medicine.medical_specialty business.industry 030209 endocrinology & metabolism Odds ratio Type 2 diabetes Disease 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences Trend analysis 0302 clinical medicine Internal medicine Diabetes mellitus Internal Medicine medicine Dementia business Glycemic Cohort study |
| Zdroj: | Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy. 12:2023-2032 |
| ISSN: | 1178-7007 |
| DOI: | 10.2147/dmso.s221179 |
| Popis: | Purpose We assessed changes in diabetes mellitus (DM) overtreatment prevalence in geriatric patients that had taken place after the introduction of the rule of therapy individualization in the Polish diabetes treatment guidelines. Patients and methods This time-trend assessment comprised two retrospective cross-sectional cohort studies of type 2 DM patients admitted to a geriatric ward in 2009-2010 (1st round) and in 2014-2015 (2nd round). A high-risk group was defined as patients on antihyperglycemic medications prior to admission, who were 80+ years old, diagnosed with dementia, end-stage renal disease, or had a history of macrovascular complications. The primary outcome measure was glycosylated A1C hemoglobin (HbA1C) ≤7.0% (53 mmol/mol). Results 213 patients in the 1st round and 83 in the 2nd round were included. Groups did not differ in age, gender, health and functional characteristics. The percentage of dementia (36.1% versus 18.8%, P=0.002) and of the high-risk cases (79.3% versus 67.7%, P=0.05) was higher in the 2nd round of the study. During the study, tight glycemic control prevalence in the high-risk group decreased significantly from 73.1% to 58.5%, P=0.04 (odds ratio 0.68, 95% CI 0.47-0.97), and the median value of HbA1c increased significantly from 6.4%, IQR 5.7-7.3 (46 mmol/mol, IQR 39-56) to 6.7%, IQR 6.1-7.9 (50 mmol/mol, IQR 43-63), P=0.03. Conclusion Despite the principle of individualization of DM therapy that was in force, after a five-year observation, the problem of DM overtreatment still concerned a large percentage of geriatric patients, although a positive trend was noted in this respect. |
| Databáze: | OpenAIRE |
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