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Clinical features and sulfonylurea usage among outpatients with diabetes aged ≥90 years in an urban diabetes clinic in Tokyo. | LitMetric

AI Article Synopsis

  • The study focused on understanding the clinical features and use of sulfonylureas in diabetes patients aged 90 and older (nonagenarians) compared to younger patients.
  • It involved a retrospective analysis of 69 nonagenarians and 857 diabetic patients under 90, revealing that a higher percentage of nonagenarians were treated with sulfonylureas (45.5%) compared to younger groups (20-27.8%).
  • Despite attempts to reduce sulfonylurea dosages due to potential hypoglycemia, many nonagenarians continued their treatment for blood sugar control, indicating a possible trend of clinical inertia among this age group.

Article Abstract

Aims/introduction: Aging of society is accelerating in many countries. The purpose of this study was to describe the clinical features and sulfonylurea usage among diabetes outpatients aged ≥90 years (nonagenarians).

Materials And Methods: This study was a retrospective observational study. The study population consisted of 69 nonagenarian diabetes outpatients and 857 diabetes outpatients aged <90 years. Patients were classified into four groups: group 1, <65 years; group 2, 65-74 years; group 3, 75-89 years; and group 4, ≥90 years. The presence of hypoglycemic episodes was defined as having self-reported symptoms, or self-monitored or clinically measured blood glucose level <70 mg/dL.

Results: The median glycated hemoglobin (HbA1c) in group 1 and group 4 was 7.0% and 7.2%, respectively (P = 0.506). The proportion of sulfonylurea treatment in group 4 was 45.5%, which is significantly higher compared with the other three groups (20.0-27.8%, P < 0.001). In group 4, there was no difference between patients with or without sulfonylurea in age, sex, body mass index, HbA1c and number of antihyperglycemic agents. Five out of 25 nonagenarian sulfonylurea-treated patients had hypoglycemic episodes within the last 2 years, their HbA1c were all 7.0 ≤ HbA1c < 8.0, and sulfonylurea or insulin was tapered in all cases after confirming hypoglycemia. Tapering dosage was attempted in all 25 sulfonylurea-treated nonagenarian patients, but 15 needed to continue sulfonylurea for glycemic control, and 10 continued sulfonylurea with unknown reasons from their medical records.

Conclusions: Although tapering the dosage of sulfonylurea was attempted in nonagenarian patients, sulfonylurea was widely continued for glycemic control. Reverse clinical inertia may exist in some sulfonylurea-treated nonagenarian patients.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9720220PMC
http://dx.doi.org/10.1111/jdi.13901DOI Listing

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