Mangé Anne-Sophie, Pagès Arnaud, Sourdet Sandrine, Cestac Philippe, McCambridge Cécile
Department of Pharmacy, Toulouse University Hospital, UPS Toulouse III Paul Sabatier University, 31000 Toulouse, France.
UMR 1027, Inserm, UPS Toulouse III Paul Sabatier University, 31000 Toulouse, France.
Pharmacy (Basel). 2021 Jun 22;9(3):115. doi: 10.3390/pharmacy9030115.
(1) Background: The latest recommendations for diabetes management adapt the objectives of glycemic control to the frailty profile in older patients. The purpose of this study was to evaluate the proportion of older patients with diabetes whose treatment deviates from the recommendations. (2) Methods: This cross-sectional observational study was conducted in older adults with known diabetes who underwent an outpatient frailty assessment in 2016. Glycated hemoglobin (HbA1c) target is between 6% and 7% for nonfrail patients and between 7% and 8% for frail patients. Frailty was evaluated using the Fried criteria. Prescriptions of glucose-lowering drugs were analyzed based on explicit and implicit criteria. (3) Results: Of 110 people with diabetes with an average age of 81.7 years, 67.3% were frail. They had a mean HbA1c of 7.11%. Of these patients, 60.9% had at least one drug therapy problem in their diabetes management and 40.9% were potentially overtreated. The HbA1c distribution in relation to the targets varied depending on frailty status ( < 0.002), with overly strict control in frail patients ( < 0.001). (4) Conclusions: Glycemic control does not seem to be routinely adjusted to the health of frail patients. Several factors can lead to overtreatment of these patients.
(1) 背景:糖尿病管理的最新建议根据老年患者的虚弱状况调整血糖控制目标。本研究的目的是评估糖尿病老年患者中治疗偏离建议的比例。(2) 方法:这项横断面观察性研究在2016年接受门诊虚弱评估的已知糖尿病老年患者中进行。非虚弱患者糖化血红蛋白(HbA1c)目标在6%至7%之间,虚弱患者在7%至8%之间。使用弗里德标准评估虚弱情况。根据明确和隐含标准分析降糖药物的处方。(3) 结果:在110名平均年龄为81.7岁的糖尿病患者中,67.3%为虚弱患者。他们的平均HbA1c为7.11%。在这些患者中,60.9%在糖尿病管理中至少存在一个药物治疗问题,40.9%可能接受了过度治疗。HbA1c分布与目标的关系因虚弱状况而异(<0.002),虚弱患者存在过度严格控制的情况(<0.001)。(4) 结论:血糖控制似乎没有根据虚弱患者的健康状况进行常规调整。几个因素可能导致这些患者接受过度治疗。