Mhd Wasem Alsabbagh1, Kerry Mansell1, Lisa M Lix2, Gary Teare3, Yvonne Shevchuk1, Xinya Lu3, Anne Champagne4, David F Blackburn5. 1. College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. 2. Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. 3. Saskatchewan Health Quality Council, Saskatoon, Saskatchewan, Canada. 4. Drug Plan and Extended Benefits Branch, Ministry of Health, Government of Saskatchewan, Regina, Saskatchewan, Canada. 5. College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Electronic address: d.blackburn@usask.ca.
Abstract
OBJECTIVE: We aimed to describe trends in the prevalence and incidence of diabetes mellitus and also report the overall use of diabetes medications among patients newly admitted to a long-term care facility (LTCF). METHODS: A retrospective cohort study was done using health administrative databases in Saskatchewan. Eligible patients were newly admitted to LTCF in Saskatchewan between 2003 and 2011 and maintained LTCF residency for at least 6 months. Prevalence of diabetes was defined with physician or hospital claims in the 2 years preceding admission. Antihyperglycemic medication use was estimated from prescription claims data during the first 6 months after LTCF admission. All data were descriptively analyzed. RESULTS: The validated case definition for diabetes (≥2 diagnostic claims) in the 2 years before or 6 months after admission was met by 16.9% of patients (2471 of 14,624). An additional 965 patients (6.6%) had a single diabetes diagnostic claim or antihyperglycemic prescriptions only. Among patients receiving antihyperglycemic therapies, 64.9% (1518 of 2338) were exclusively managed with oral medications, and metformin was the most commonly used medication. Glyburide was commonly withdrawn after LTCF admission. Insulin use was observed in 23.9% of diabetes patients, with a mean daily average consumption of 54.7 units per day. CONCLUSIONS: Use of diabetes medications appear to generally align with Canadian practice recommendations as evidenced by declining use of glyburide and frequent use of metformin. Future studies should examine clinical benefits and safety of hypoglycemic agent use in LTCFs.
OBJECTIVE: We aimed to describe trends in the prevalence and incidence of diabetes mellitus and also report the overall use of diabetes medications among patients newly admitted to a long-term care facility (LTCF). METHODS: A retrospective cohort study was done using health administrative databases in Saskatchewan. Eligible patients were newly admitted to LTCF in Saskatchewan between 2003 and 2011 and maintained LTCF residency for at least 6 months. Prevalence of diabetes was defined with physician or hospital claims in the 2 years preceding admission. Antihyperglycemic medication use was estimated from prescription claims data during the first 6 months after LTCF admission. All data were descriptively analyzed. RESULTS: The validated case definition for diabetes (≥2 diagnostic claims) in the 2 years before or 6 months after admission was met by 16.9% of patients (2471 of 14,624). An additional 965 patients (6.6%) had a single diabetes diagnostic claim or antihyperglycemic prescriptions only. Among patients receiving antihyperglycemic therapies, 64.9% (1518 of 2338) were exclusively managed with oral medications, and metformin was the most commonly used medication. Glyburide was commonly withdrawn after LTCF admission. Insulin use was observed in 23.9% of diabetespatients, with a mean daily average consumption of 54.7 units per day. CONCLUSIONS: Use of diabetes medications appear to generally align with Canadian practice recommendations as evidenced by declining use of glyburide and frequent use of metformin. Future studies should examine clinical benefits and safety of hypoglycemic agent use in LTCFs.
Authors: Sonya J Wolf; Christopher O Audu; Amrita Joshi; Aaron denDekker; William J Melvin; Frank M Davis; Xianying Xing; Rachael Wasikowski; Lam C Tsoi; Steven L Kunkel; Johann E Gudjonsson; Mary X O'Riordan; J Michelle Kahlenberg; Katherine A Gallagher Journal: JCI Insight Date: 2022-05-09
Authors: Francisco J Pasquel; Winter Powell; Limin Peng; Theodore M Johnson; Shadi Sadeghi-Yarandi; Christopher Newton; Dawn Smiley; Marcos T Toyoshima; Pedram Aram; Guillermo E Umpierrez Journal: BMJ Open Diabetes Res Care Date: 2015-08-28