Characteristics of the clinical treatment of Brazilian and French older adults with diabetes

Bezerra, Carina Bandeira; Pinho, Claudio de Brito Ramos Pinto; Saintrain, Maria Vieira de Lima; Sodré, Ana Karina De Melo Bezerra; Silva, Carlos Antônio Bruno da; Doucet, J.

doi:10.1016/j.diabres.2021.109088

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…First, GLD types differ with regard to their probability of precipitating hypoglycemia, whose frequency has been shown to correlate with frailty incidence [ 7 ]. A multi-national study disclosed that insulin users exhibited higher risk of hypoglycemia than oGLD combination users [ 37 ], suggesting that insulin use could indirectly modulate their frailty risk. Second, insulin users might harbor features that necessitate insulin use, including a greater degree of insulin resistance than oGLD users.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Glucose-Lowering Strategy on the Risk of Increasing Frailty Severity among 49,519 Patients with Diabetes Mellitus: A Longitudinal Cohort Study

Chi¹,

Wang²,

Lee³

et al. 2023

Aging and disease

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Patients with diabetes mellitus (DM) have a higher risk of incident and aggravating frailty over time. Frailty-initiating risk factors have been identified, but modulators of frail severity over time remain poorly defined. We aimed to explore the influences of glucose-lowering drug (GLD) strategy on DM patients' risk of increasing frail severity. We retrospectively identified type 2 DM patients between 2008 and 2016, dividing them into "no GLD", oral GLD (oGLD) monotherapy, oGLD combination, and those receiving insulin without or with oGLD at baseline. Increasing frail severity, defined as ≥1 FRAIL component increase, was the outcome of interest. Cox proportional hazard regression was utilized to analyze the risk of increasing frail severity associated with GLD strategy, accounting for demographic, physical data, comorbidities, medication, and laboratory panel. After screening 82,208 patients with DM, 49,519 (no GLD, 42.7%; monotherapy, 24.0%; combination, 28.5%; and insulin user, 4.8%) were enrolled for analysis. After 4 years, 12,295 (24.8%) had increasing frail severity. After multivariate adjustment, oGLD combination group exhibited a significantly lower risk of increasing frail severity (hazard ratio (HR) 0.90, 95% confidence interval (CI) 0.86 -0.94), while the risk of insulin users increased (HR 1.11, 95% CI 1.02 -1.21) than no GLD group. Users receiving more oGLD exhibited a trend of less risk reduction relative to others. In conclusion, we discovered that the strategy of oral glucose lowering drugs combination might reduce the risk of frail severity increase. Accordingly, medication reconciliation in frail diabetic older adults should take into account their GLD regimens.

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Section: Discussionmentioning

confidence: 99%

The Impact of Glucose-Lowering Strategy on the Risk of Increasing Frailty Severity among 49,519 Patients with Diabetes Mellitus: A Longitudinal Cohort Study

Chi¹,

Wang²,

Lee³

et al. 2023

Aging and disease

View full text Add to dashboard Cite

show abstract

“…Therapeutic guidelines vary depending on each patient since glycemic control is recommended to be less strict in this group of older patients. Furthermore, the multiple comorbidities, such as sarcopenia and frailty, that these patients usually present influence the therapeutic scheme of the elderly compared to the younger population [ 3 ]. A global and comprehensive evaluation of the elderly patient with T2DM is essential, with the aim to achieve a good quality of life, preserve the functionality of the patient, and avoid complications, mainly hypoglycemia [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Management of Type 2 Diabetes Mellitus in Elderly Patients with Frailty and/or Sarcopenia

Sanz-Cánovas

López-Sampalo

Cobos-Palacios

et al. 2022

IJERPH

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The life expectancy of the population is increasing worldwide due to improvements in the prevention, diagnosis, and treatment of diseases. This favors a higher prevalence of type 2 diabetes mellitus (T2DM) in the elderly. Sarcopenia and frailty are also frequently present in aging. These three entities share common mechanisms such as insulin resistance, chronic inflammation, and mitochondrial dysfunction. The coexistence of these situations worsens the prognosis of elderly patients. In this paper, we review the main measures for the prevention and management of sarcopenia and/or frailty in elderly patients with T2DM.

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La cohorte GERODIAB : synthèse des résultats à 5 ans

Doucet,

Bauduceau,

Hilbert

et al. 2023

Médecine des Maladies Métaboliques

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Characteristics of the clinical treatment of Brazilian and French older adults with diabetes

Cited by 3 publications

References 16 publications

The Impact of Glucose-Lowering Strategy on the Risk of Increasing Frailty Severity among 49,519 Patients with Diabetes Mellitus: A Longitudinal Cohort Study

The Impact of Glucose-Lowering Strategy on the Risk of Increasing Frailty Severity among 49,519 Patients with Diabetes Mellitus: A Longitudinal Cohort Study

Management of Type 2 Diabetes Mellitus in Elderly Patients with Frailty and/or Sarcopenia

La cohorte GERODIAB : synthèse des résultats à 5 ans

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