4490064f5ed66786bea89304ac8fbf7f 283199.pdf e68597dd2b6d2a96fe13a184b84f811f8e33778b 283199.pdf 7ae902f51de27c9007ba73440c55dff2a5dfc82ac68cc1e4ff6de724aaa09d1b 283199.pdf Title: Potential Risk of Overtreatment in Patients with Type 2 Diabetes Aged 75 Years or Older: Data from a Population Database in Catalonia, Spain Subject: Aim: To assess the potential risk of overtreatment in patients with type 2 diabetes (T2DM) aged 75 years or older in primary care. Methods: Electronic health records retrieved from the SIDIAP database (Catalonia, Spain) in 2016. Variables: age, gender, body mass index, registered hypoglycemia, last HbA1c and glomerular filtration rates, and prescriptions for antidiabetic drugs. Potential overtreatment was defined as having HbA1c < 7% or HbA1c < 6.5% in older patients treated with insulin, sulfonylureas, or glinides. Results: From a total population of 138,374 T2DM patients aged 75 years or older, 123,515 had at least one HbA1c available. An HbA1c below 7.0% was present in 59.1% of patients, and below 6.5% in 37.7%. Overall, 23.0% of patients were treated with insulin, 17.8% with sulfonylureas, and 6.6% with glinides. Potential overtreatment (HbA1c < 7%) was suspected in 26.6% of patients treated with any high-risk drug, 47.8% with sulfonylureas, 43.5% with glinides, and 28.1% with insulin. Using the threshold of HbA1c < 6.5%, these figures were: 21.6%, 24.4%, 17.9%, and 12.3%, respectively. Conclusion: One in four older adults with T2DM treated with antidiabetic drugs associated with a high risk of hypoglycemia might be at risk of overtreatment. This risk is higher in those treated with sulfonylureas or glinides than with insulin. Keywords: type 2 diabetes; treatment; overtreatment; older diabetes adults Author: Manel Mata-Cases, Didac Mauricio, Jordi Real, Bogdan Vlacho, Laura Romera-Liebana, Núria Molist-Brunet, Marta Cedenilla and Josep Franch-Nadal Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu Sep 1 07:48:22 2022 CEST ModDate: Thu Sep 1 07:53:47 2022 CEST Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1333366 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YQMKHR+VnURWPalladioL Type 1 Custom yes yes no 10 0 WOJATE+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 WRDOAZ+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 PBKKFN+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 ENLEMO+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 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WinAnsi yes yes no 247 0 FGGNLG+ArialNarrow TrueType WinAnsi yes yes no 250 0 FGGNLH+Calibri CID TrueType Identity-H yes yes yes 253 0 OPBMBK+Calibri CID TrueType Identity-H yes yes yes 272 0 OPCAGD+ArialNarrow TrueType WinAnsi yes yes no 278 0 OPDNJC+CordiaNew TrueType WinAnsi yes yes no 281 0 OPBKDL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 284 0 OPBKDN+PalatinoLinotype TrueType WinAnsi yes yes no 287 0 OPBKDP+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 290 0 KGSZMU+VnURWPalladioL-Italic Type 1 Custom yes yes no 302 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-10-24 02:25:39 CEST RepresentationInformation: 283199.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-10-23 13:50:38 CEST Size: 1333366 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 504 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Item: Title: Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Children: Item: Title: Study Eligibility Criteria Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: Study Variables Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Statistical Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Ethics Committee Approval Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Children: Item: Title: Antidiabetic Treatment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1a3869f4 Item: Title: Potential Overtreatment Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@a38d7a3 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77f99a05 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@63440df3 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@3aeaafa6 Info: Title: Potential Risk of Overtreatment in Patients with Type 2 Diabetes Aged 75 Years or Older: Data from a Population Database in Catalonia, Spain Author: Manel Mata-Cases, Didac Mauricio, Jordi Real, Bogdan Vlacho, Laura Romera-Liebana, Núria Molist-Brunet, Marta Cedenilla and Josep Franch-Nadal Subject: Aim: To assess the potential risk of overtreatment in patients with type 2 diabetes (T2DM) aged 75 years or older in primary care. Methods: Electronic health records retrieved from the SIDIAP database (Catalonia, Spain) in 2016. Variables: age, gender, body mass index, registered hypoglycemia, last HbA1c and glomerular filtration rates, and prescriptions for antidiabetic drugs. Potential overtreatment was defined as having HbA1c < 7% or HbA1c < 6.5% in older patients treated with insulin, sulfonylureas, or glinides. Results: From a total population of 138,374 T2DM patients aged 75 years or older, 123,515 had at least one HbA1c available. An HbA1c below 7.0% was present in 59.1% of patients, and below 6.5% in 37.7%. Overall, 23.0% of patients were treated with insulin, 17.8% with sulfonylureas, and 6.6% with glinides. Potential overtreatment (HbA1c < 7%) was suspected in 26.6% of patients treated with any high-risk drug, 47.8% with sulfonylureas, 43.5% with glinides, and 28.1% with insulin. Using the threshold of HbA1c < 6.5%, these figures were: 21.6%, 24.4%, 17.9%, and 12.3%, respectively. Conclusion: One in four older adults with T2DM treated with antidiabetic drugs associated with a high risk of hypoglycemia might be at risk of overtreatment. This risk is higher in those treated with sulfonylureas or glinides than with insulin. 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