A Retrospective Time Trend Study Of Diabetes Overtreatment In Geriatric Patients

Zyta Beata Wojszel,1,2 Agnieszka Kasiukiewicz1,2 1Department of Geriatrics, Medical University of Bialystok, Bialystok, Poland; 2Department of Geriatrics, Hospital of the Ministry of Interior in Bialystok, Bialystok, PolandCorrespondence: Zyta Beata WojszelDepartment of Geriatrics, Medical Universit...

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Autores principales:	Wojszel ZB, Kasiukiewicz A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	type 2 diabetes older people therapy individualization glycosylated A1C hemoglobin HbA1c tight control Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/87b96b6cd3d84530b0c6be5afd8e36e2
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spelling	oai:doaj.org-article:87b96b6cd3d84530b0c6be5afd8e36e22021-12-02T06:18:16ZA Retrospective Time Trend Study Of Diabetes Overtreatment In Geriatric Patients1178-7007https://doaj.org/article/87b96b6cd3d84530b0c6be5afd8e36e22019-10-01T00:00:00Zhttps://www.dovepress.com/a-retrospective-time-trend-study-of-diabetes-overtreatment-in-geriatri-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Zyta Beata Wojszel,1,2 Agnieszka Kasiukiewicz1,2 1Department of Geriatrics, Medical University of Bialystok, Bialystok, Poland; 2Department of Geriatrics, Hospital of the Ministry of Interior in Bialystok, Bialystok, PolandCorrespondence: Zyta Beata WojszelDepartment of Geriatrics, Medical University of Bialystok, Fabryczna street 27, Bialystok 15-471, PolandTel +48 85 8694 982Fax +48 85 8694974Email wojszel@umb.edu.plPurpose: 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.Keywords: type 2 diabetes, older people, therapy individualization, glycosylated A1C hemoglobin, HbA1c, tight controlWojszel ZBKasiukiewicz ADove Medical Pressarticletype 2 diabetesolder peopletherapy individualizationglycosylated A1C hemoglobinHbA1ctight controlSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 12, Pp 2023-2032 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	type 2 diabetes older people therapy individualization glycosylated A1C hemoglobin HbA1c tight control Specialties of internal medicine RC581-951
spellingShingle	type 2 diabetes older people therapy individualization glycosylated A1C hemoglobin HbA1c tight control Specialties of internal medicine RC581-951 Wojszel ZB Kasiukiewicz A A Retrospective Time Trend Study Of Diabetes Overtreatment In Geriatric Patients
description	Zyta Beata Wojszel,1,2 Agnieszka Kasiukiewicz1,2 1Department of Geriatrics, Medical University of Bialystok, Bialystok, Poland; 2Department of Geriatrics, Hospital of the Ministry of Interior in Bialystok, Bialystok, PolandCorrespondence: Zyta Beata WojszelDepartment of Geriatrics, Medical University of Bialystok, Fabryczna street 27, Bialystok 15-471, PolandTel +48 85 8694 982Fax +48 85 8694974Email wojszel@umb.edu.plPurpose: 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.Keywords: type 2 diabetes, older people, therapy individualization, glycosylated A1C hemoglobin, HbA1c, tight control
format	article
author	Wojszel ZB Kasiukiewicz A
author_facet	Wojszel ZB Kasiukiewicz A
author_sort	Wojszel ZB
title	A Retrospective Time Trend Study Of Diabetes Overtreatment In Geriatric Patients
title_short	A Retrospective Time Trend Study Of Diabetes Overtreatment In Geriatric Patients
title_full	A Retrospective Time Trend Study Of Diabetes Overtreatment In Geriatric Patients
title_fullStr	A Retrospective Time Trend Study Of Diabetes Overtreatment In Geriatric Patients
title_full_unstemmed	A Retrospective Time Trend Study Of Diabetes Overtreatment In Geriatric Patients
title_sort	retrospective time trend study of diabetes overtreatment in geriatric patients
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/87b96b6cd3d84530b0c6be5afd8e36e2
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A Retrospective Time Trend Study Of Diabetes Overtreatment In Geriatric Patients

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