Antoine Christiaens1,2,3, Séverine Henrard4,5, Benoit Boland5,6. 1. Fund for Scientific Research - FNRS, Brussels, Belgium. antoine.christiaens@uclouvain.be. 2. Clinical Pharmacy Research Group, Louvain Drug Research Institute (LDRI), Université catholique de Louvain, Brussels, Belgium. antoine.christiaens@uclouvain.be. 3. Institute of Health and Society (IRSS), Université catholique de Louvain, 30, Clos Chapelle-Aux-Champs bte B1.30.15, 1200, Brussels, Belgium. antoine.christiaens@uclouvain.be. 4. Clinical Pharmacy Research Group, Louvain Drug Research Institute (LDRI), Université catholique de Louvain, Brussels, Belgium. 5. Institute of Health and Society (IRSS), Université catholique de Louvain, 30, Clos Chapelle-Aux-Champs bte B1.30.15, 1200, Brussels, Belgium. 6. Geriatric Medicine, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium.
Abstract
PURPOSE: In geriatric patients with type 2 diabetes (T2D), appropriate glycaemic control is crucial to avoid overtreatment and hypoglycaemia. This study compared glycaemic control appropriateness across three major clinical practice guidelines (CPGs). METHODS: Retrospective study of geriatric older inpatients with T2D and glucose-lowering treatment before admission. Patients were classified as appropriately treated, overtreated or undertreated using CPGs from Diabetes Canada 2018 (DC18), the Endocrine Society 2019 (ES19) and the American Diabetes Association 2021 (ADA21). RESULTS: Of the 318 geriatric patients (median age 84 years, 54% women, 66% in poor health), 46%, 25% and 82% were appropriately treated, while 38%, 57% and 0% were overtreated, based on DC18, ES19 and ADA21, respectively. CONCLUSION: Large discrepancy of glycaemic control appropriateness was detected across these CPGs and concerned mainly overtreatment. This finding relates to the absence in ADA21 of a lower HbA1c value, which may be an obstacle to the prevention of hypoglycaemia.
PURPOSE: In geriatric patients with type 2 diabetes (T2D), appropriate glycaemic control is crucial to avoid overtreatment and hypoglycaemia. This study compared glycaemic control appropriateness across three major clinical practice guidelines (CPGs). METHODS: Retrospective study of geriatric older inpatients with T2D and glucose-lowering treatment before admission. Patients were classified as appropriately treated, overtreated or undertreated using CPGs from Diabetes Canada 2018 (DC18), the Endocrine Society 2019 (ES19) and the American Diabetes Association 2021 (ADA21). RESULTS: Of the 318 geriatric patients (median age 84 years, 54% women, 66% in poor health), 46%, 25% and 82% were appropriately treated, while 38%, 57% and 0% were overtreated, based on DC18, ES19 and ADA21, respectively. CONCLUSION: Large discrepancy of glycaemic control appropriateness was detected across these CPGs and concerned mainly overtreatment. This finding relates to the absence in ADA21 of a lower HbA1c value, which may be an obstacle to the prevention of hypoglycaemia.
Keywords:
Clinical practice guidelines; Geriatric patients; Glucose-lowering treatment; Glycaemic control appropriateness; Overtreatment; Type 2 diabetes
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