We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Is there evidence of potential overtreatment of glycaemia in elderly people with type 2 diabetes? Data from the GUIDANCE study.
- Authors
Kuss, Oliver; Müller, Nicolle; Roth, Johannes; Müller, Ulrich; Khunti, Kamlesh; Lindblad, Ulf; Nolan, John; Rutten, Guy; Trento, Marina; Porta, Massimo; Charpentier, Guillaume; Jörgens, Viktor
- Abstract
Aims: We used data from the GUIDANCE Study to determine the care of people with type 2 diabetes according to age and accompanying cardiovascular diseases and to assess indicators of overtreatment of glycaemia. Methods: The GUIDANCE study was a retrospective, cross-sectional study from 2009-2010 based on the records of 7597 people in France, Belgium, Italy, the Netherlands, Sweden, UK, Ireland and Germany. We analysed the level of metabolic control achieved and blood glucose-lowering medication used in different age groups and in relation to accompanying diseases. Results: 4.459 patients (59.1%) were 65 years or older. Their HbA1c levels were similar to those with <65 years. 44.7% of patients ≥65 years had an HbA1c ≤7% (53 mmol/mol) and were treated with insulin or sulfonylureas, and 27.1% of them had ischaemic heart disease or congestive heart failure. Significantly more patients with heart disease had HbA1c values ≤7% (53 mmol/mol) and were treated more often with insulin or sulfonylureas compared to patients of the same age without heart disease. Conclusions: Most patients were treated according to guidelines valid at the time this large international patient sample was surveyed. Older and younger patients were at a similar level of metabolic control, and almost half of the patients with an age of ≥65 years and treated with insulin or sulfonylurea had HbA1c levels below the target range (≤7%) for younger patients. However, these patients have an increased risk of severe hypoglycaemic events with potentially dangerous complications, particularly in those with cardiovascular diseases.
- Subjects
TYPE 2 diabetes; OVERTREATMENT; HYPOGLYCEMIA; THERAPEUTICS; CARDIOVASCULAR diseases; GLYCOSYLATED hemoglobin
- Publication
Acta Diabetologica, 2017, Vol 54, Issue 2, p209
- ISSN
0940-5429
- Publication type
Article
- DOI
10.1007/s00592-016-0939-9