Effect of deprescribing in elderly patients with type 2 diabetes: iDegLira might improve quality of life

Older people with type 2 diabetes (T2D) often have several comorbidities and take multiple drugs. This study tested a deprescribing strategy in older T2D patients, replacing a hypoglycemic therapeutic scheme with a single drug combination (iDegLira). In this 6-month, real-world, single-arm, open int...

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Autores principales:	Stefano Rizza, Giacomo Piciucchi, Maria Mavilio, Susanna Longo, Martina Montagna, Riccardo Tatonetti, Alessandro Nucera, Massimo Federici
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Diabetes Elderly Deprescribing Quality of life IDegLira Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/23005c506fe34d1e9d75ee4dc553f203
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spelling	oai:doaj.org-article:23005c506fe34d1e9d75ee4dc553f2032021-11-14T04:30:02ZEffect of deprescribing in elderly patients with type 2 diabetes: iDegLira might improve quality of life0753-332210.1016/j.biopha.2021.112341https://doaj.org/article/23005c506fe34d1e9d75ee4dc553f2032021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S0753332221011252https://doaj.org/toc/0753-3322Older people with type 2 diabetes (T2D) often have several comorbidities and take multiple drugs. This study tested a deprescribing strategy in older T2D patients, replacing a hypoglycemic therapeutic scheme with a single drug combination (iDegLira). In this 6-month, real-world, single-arm, open interventional study, we enrolled patients ≥ 75 years with T2D taking ≥ 2 medications for diabetes. Patients on a basal-bolus insulin regimen (n = 13), on a basal-insulin regimen plus oral glucose-lowering drugs (n = 9), and those on oral glucose-lowering drugs (n = 18) were switched to daily iDegLira. The primary clinical endpoint of the study was an improvement in CASP-19 and/or DTSQ score after 6 months. We also evaluated changes in glucose metabolism, depression, cognitive function, level of independence, and markers of inflammation. Thirty-five patients (12 women, mean age=81.4 y) completed the protocol. Results shown here are given as estimated mean difference (95%CI). DTSQ score improved [11.08 (7.13/15.02); p = 0.0001], whereas CASP-19 did not after 6 months of iDegLira treatment. We observed reductions in BMI [− 0.81 (− 1.27/0.35); p < 0.001], fasting glucose [− 52.07 (− 77.26/26.88); p < 0.001], HbA1c [− 0.58 (− 1.08/0.08); p < 0.05], and TNF-α [− 1.83 (− 3.12/− 0.54); p = 0.007]. Activities of daily living and cognitive function score increased [p = 0.006 and p = 0.02], whereas depression score significantly decreased [p = 0.02]. Notably, no patient reported episodes of severe hypoglycemia after initiation of iDegLira treatment. Among older patients with T2D, deprescribing using a single dose of iDegLira resulted in a greater likelihood of improving health and quality of life. Although our data indicate the effectiveness and safety of this approach, it must be confirmed in larger studies.Stefano RizzaGiacomo PiciucchiMaria MavilioSusanna LongoMartina MontagnaRiccardo TatonettiAlessandro NuceraMassimo FedericiElsevierarticleDiabetesElderlyDeprescribingQuality of lifeIDegLiraTherapeutics. PharmacologyRM1-950ENBiomedicine & Pharmacotherapy, Vol 144, Iss , Pp 112341- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diabetes Elderly Deprescribing Quality of life IDegLira Therapeutics. Pharmacology RM1-950
spellingShingle	Diabetes Elderly Deprescribing Quality of life IDegLira Therapeutics. Pharmacology RM1-950 Stefano Rizza Giacomo Piciucchi Maria Mavilio Susanna Longo Martina Montagna Riccardo Tatonetti Alessandro Nucera Massimo Federici Effect of deprescribing in elderly patients with type 2 diabetes: iDegLira might improve quality of life
description	Older people with type 2 diabetes (T2D) often have several comorbidities and take multiple drugs. This study tested a deprescribing strategy in older T2D patients, replacing a hypoglycemic therapeutic scheme with a single drug combination (iDegLira). In this 6-month, real-world, single-arm, open interventional study, we enrolled patients ≥ 75 years with T2D taking ≥ 2 medications for diabetes. Patients on a basal-bolus insulin regimen (n = 13), on a basal-insulin regimen plus oral glucose-lowering drugs (n = 9), and those on oral glucose-lowering drugs (n = 18) were switched to daily iDegLira. The primary clinical endpoint of the study was an improvement in CASP-19 and/or DTSQ score after 6 months. We also evaluated changes in glucose metabolism, depression, cognitive function, level of independence, and markers of inflammation. Thirty-five patients (12 women, mean age=81.4 y) completed the protocol. Results shown here are given as estimated mean difference (95%CI). DTSQ score improved [11.08 (7.13/15.02); p = 0.0001], whereas CASP-19 did not after 6 months of iDegLira treatment. We observed reductions in BMI [− 0.81 (− 1.27/0.35); p < 0.001], fasting glucose [− 52.07 (− 77.26/26.88); p < 0.001], HbA1c [− 0.58 (− 1.08/0.08); p < 0.05], and TNF-α [− 1.83 (− 3.12/− 0.54); p = 0.007]. Activities of daily living and cognitive function score increased [p = 0.006 and p = 0.02], whereas depression score significantly decreased [p = 0.02]. Notably, no patient reported episodes of severe hypoglycemia after initiation of iDegLira treatment. Among older patients with T2D, deprescribing using a single dose of iDegLira resulted in a greater likelihood of improving health and quality of life. Although our data indicate the effectiveness and safety of this approach, it must be confirmed in larger studies.
format	article
author	Stefano Rizza Giacomo Piciucchi Maria Mavilio Susanna Longo Martina Montagna Riccardo Tatonetti Alessandro Nucera Massimo Federici
author_facet	Stefano Rizza Giacomo Piciucchi Maria Mavilio Susanna Longo Martina Montagna Riccardo Tatonetti Alessandro Nucera Massimo Federici
author_sort	Stefano Rizza
title	Effect of deprescribing in elderly patients with type 2 diabetes: iDegLira might improve quality of life
title_short	Effect of deprescribing in elderly patients with type 2 diabetes: iDegLira might improve quality of life
title_full	Effect of deprescribing in elderly patients with type 2 diabetes: iDegLira might improve quality of life
title_fullStr	Effect of deprescribing in elderly patients with type 2 diabetes: iDegLira might improve quality of life
title_full_unstemmed	Effect of deprescribing in elderly patients with type 2 diabetes: iDegLira might improve quality of life
title_sort	effect of deprescribing in elderly patients with type 2 diabetes: ideglira might improve quality of life
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/23005c506fe34d1e9d75ee4dc553f203
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Effect of deprescribing in elderly patients with type 2 diabetes: iDegLira might improve quality of life

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