Overtreatment and Hypoglycemia Prevalence in Geriatric Patients with Type-2 Diabetes in the Turkish Population

Akın, Seydahmet; Bölük, Cem; Özgür, Yasemin; Aladağ, Nazire Başkurt; Gecmez, Gizem; Keskın, Onur; Börü, Ülkü Türk; Taşdemir, Mustafa

doi:10.4183/aeb.2019.311

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…The 8 non‐individualised definitions of diabetes overtreatment were all based on a HbA 1c threshold and for 6 of them, additionally on the presence of a GLT (Table 2). Indeed, 2 definitions took only HbA 1c values into account, 28,29,31,40 4 definitions required the use of any GL agent(s) 22,23,25,27,34 and 2 definitions required the use of a GLT inducing a high risk of hypoglycaemia, i.e. a GLT including insulin, sulfonylurea or a glinide 15,20,24,30,32,35,37–39 .…”

Section: Resultsmentioning

confidence: 99%

Overtreatment of older people with type 2 diabetes—a high impact frequent occurrence in need of a new definition

et al. 2022

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Background Diabetes overtreatment is a frequent and major issue in older people with type 2 diabetes but its definition is often inconsistent and may be misleading. This critical review has aimed at examining the definitions of diabetes overtreatment in older people used in research studies. Methods Studies addressing diabetes overtreatment in people aged 65 or older were identified by searching the PubMed database according to an extensive search equation. Results Twenty‐two research studies providing a definition of diabetes overtreatment in people aged were found. Overall, 12 different definitions of diabetes overtreatment were used. All studies defined overtreatment according to a HbA1c threshold (varying from <42 mmol/mol [<6.0%] to <64 mmol/mol [<8%]). Amongst them, 2 definitions had no consideration about glucose‐lowering (GL) treatment, 6 required the prescribing of ≥1 GL agent(s), and 4 the prescribing of ≥1 GL agent(s) inducing the high risk of hypoglycaemia (i.e., sulfonylurea(s) or insulin(s)). Only 4 definitions (four studies) were individualised, using varying HbA1c thresholds according to patients' age or health status. Conclusions Definitions of diabetes overtreatment are heterogeneous across research studies, which is confusing. A standardised definition, based on the individual risk of hypoglycaemia and/or its complications must be promoted in order to bring clarity and greater insight into this field, as well as to improve the quality of management of diabetes in older patients.

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Section: Resultsmentioning

confidence: 99%

Overtreatment of older people with type 2 diabetes—a high impact frequent occurrence in need of a new definition

et al. 2022

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Glycaemic control and its associated factors in patients with type 2 diabetes in the Middle East and North Africa: An updated systematic review and meta‐analysis

Al-ma’aitah

Demant

Jakimowicz

et al. 2022

Journal of Advanced Nursing

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Diabetes is a major public health issue with an increasing burden globally (Johar et al., 2019). The latest data show that in 2019, 463 million adults were living with diabetes. It has been estimated that, without action to reduce the rising prevalence, by 2030, 578 million people will live with diabetes (Williams et al., 2019). One of the most affected areas is the Middle Eastern and North African (MENA) region, where approximately 54.8 million adults aged 20-79 were living with diabetes in 2019 (Williams et al., 2019). It was estimated that the number

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Overuse of medications in low- and middle-income countries: a scoping review

Albarqouni

Palagama

Chai

et al. 2023

Bull World Health Organ

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Objective To identify and summarize the evidence about the extent of overuse of medications in low- and middle-income countries, its drivers, consequences and potential solutions. Methods We conducted a scoping review by searching the databases PubMed®, Embase®, APA PsycINFO® and Global Index Medicus using a combination of MeSH terms and free text words around overuse of medications and overtreatment. We included studies in any language published before 25 October 2021 that reported on the extent of overuse, its drivers, consequences and solutions. Findings We screened 3489 unique records and included 367 studies reporting on over 5.1 million prescriptions across 80 low- and middle-income countries – with studies from 58.6% (17/29) of all low-, 62.0% (31/50) of all lower-middle- and 60.0% (33/55) of all upper-middle-income countries. Of the included studies, 307 (83.7%) reported on the extent of overuse of medications, with estimates ranging from 7.3% to 98.2% (interquartile range: 30.2–64.5). Commonly overused classes included antimicrobials, psychotropic drugs, proton pump inhibitors and antihypertensive drugs. Drivers included limited knowledge of harms of overuse, polypharmacy, poor regulation and financial influences. Consequences were patient harm and cost. Only 11.4% (42/367) of studies evaluated solutions, which included regulatory reforms, educational, deprescribing and audit–feedback initiatives. Conclusion Growing evidence suggests overuse of medications is widespread within low- and middle-income countries, across multiple drug classes, with few data of solutions from randomized trials. Opportunities exist to build collaborations to rigorously develop and evaluate potential solutions to reduce overuse of medications.

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Overtreatment and Hypoglycemia Prevalence in Geriatric Patients with Type-2 Diabetes in the Turkish Population

Cited by 3 publications

References 25 publications

Overtreatment of older people with type 2 diabetes—a high impact frequent occurrence in need of a new definition

Overtreatment of older people with type 2 diabetes—a high impact frequent occurrence in need of a new definition

Glycaemic control and its associated factors in patients with type 2 diabetes in the Middle East and North Africa: An updated systematic review and meta‐analysis

Overuse of medications in low- and middle-income countries: a scoping review

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