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Is there evidence of potential overtreatment of glycaemia in elderly people with type 2 diabetes? Data from the GUIDANCE study

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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  • Nicolle Müller
  • Kamlesh Khunti
  • Oliver Kuss
  • Ulf Lindblad
  • John Nolan
  • Guy Ehm Rutten
  • Marina Trento
  • Massimo Porta
  • Johannes Roth
  • Guillaume Charpentier
  • Viktor Jörgens
  • Ulrich A Müller
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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.

OriginalsprogEngelsk
TidsskriftActa Diabetologica
Vol/bind54
Udgave nummer2
Sider (fra-til)209-214
Antal sider6
ISSN0940-5429
DOI
StatusUdgivet - feb. 2017

ID: 51480312