Diabetes: glycemic targets and over-treatment in older patients

Diabetic glycemic targets in older patients must reflect their preferences, clinical status and life expectancy. The presence of multiple comorbidities as well as functional or cognitive impairment are better predictors than age alone of both limited life expectancy and reduced benefit of intensive...

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Bibliographic Details
Published in:	Revue médicale suisse Vol. 12; no. 508; p. 461
Main Authors:	Deletre, Sylviane, Coutaz, Martial
Format:	Journal Article
Language:	French
Published:	Switzerland 02-03-2016
Subjects:	Aged Aged, 80 and over Aging Biomarkers - blood Blood Glucose - metabolism Body Mass Index Comorbidity Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - epidemiology Female Geriatrics Glycated Hemoglobin A - metabolism Hospitals Humans Hypoglycemic Agents - therapeutic use Incidence Inpatients - statistics & numerical data Life Expectancy Male Medical Overuse - prevention & control Retrospective Studies Risk Factors Switzerland - epidemiology
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Summary:	Diabetic glycemic targets in older patients must reflect their preferences, clinical status and life expectancy. The presence of multiple comorbidities as well as functional or cognitive impairment are better predictors than age alone of both limited life expectancy and reduced benefit of intensive treatment. For most of these patients, the harms of intensive diabetes therapy outweigh the benefits. Our retrospective study analyzing 257 diabetic patients hospitalized in a geriatric ward shows a very high incidence of over-treatment and suggests the need to review our practices and to adopt individualized treatment goals.
ISSN:	1660-9379