ArticleDiabetes care2015
Tight glycemic control and use of hypoglycemic medications in older veterans with type 2 diabetes and comorbid dementia.
Article in Diabetes care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
62 citing papers in PubMed, 1 synthesis or guideline pooled it.
- 2023 Clinical Practice Guidelines for Diabetes Management in Korea: Full Version Recommendation of the Korean Diabetes Association.Diabetes & metabolism journal · 2024Guideline
- Benefits of insulin degludec/liraglutide are maintained even in patients discontinuing sulphonylureas or dipeptidyl peptidase-4 inhibitors upon initiation of degludec/liraglutide therapy: A post hoc analysis of the DUAL II and DUAL IX trials.Diabetes, obesity & metabolism · 2020Trial
- Impact and Feasibility of Personalized Decision Support for Older Patients with Diabetes: A Pilot Randomized Trial.Medical decision making : an international journal of the Society for Medical Decision Making · 2017Trial
- The cognitive consequences of hypoglycemia in diabetes.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026Review
- Burden of Hypoglycemia and Hyperglycemia in Insulin-Treated Veterans Affairs Nursing Home Residents.Journal of the American Geriatrics Society · 2026Article
- 13. Older Adults: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- Facilitators of and Barriers to Deprescribing Diabetes Medications in Older Adults: A Qualitative Study.Journal of the American Geriatrics Society · 2025Article
- Realigning diabetes regimens in older adults: a 4S Pathway to guide simplification and deprescribing strategies.The lancet. Diabetes & endocrinology · 2025Review
- 13. Older Adults: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
- A nurse driven care management program to engage older diabetes patients in personalized goal setting and disease management.Health science reports · 2024Article
- Clinician and Family Caregiver Perspectives on Deprescribing Chronic Disease Medications in Older Nursing Home Residents Near the End of Life.Drugs & aging · 2024Article
- Should dietary restrictions be imposed on Alzheimer's Disease patients affected by type 2 diabetes?Dialogues in clinical neuroscience · 2024Article
- 13. Older Adults: Standards of Care in Diabetes-2024.Diabetes care · 2024Review
- High number of hypoglycaemic episodes identified by CGM among home-dwelling older people with diabetes: an observational study in Norway.BMC endocrine disorders · 2023Observational
- Diabetes Medication Changes in Older Adults With Type 2 Diabetes: Insights Into Physician Factors and Questions Ahead.Diabetes care · 2023Article
- Metabolic Characteristics of Frail Older People with Diabetes Mellitus-A Systematic Search for Phenotypes.Metabolites · 2023Review
- 13. Older Adults: Standards of Care in Diabetes-2023.Diabetes care · 2023Review
- Fingerstick glucose monitoring by cognitive impairment status in Veterans Affairs nursing home residents with diabetes.Journal of the American Geriatrics Society · 2022Article
- Initiating second-line antidiabetic medication among older adults with type 2 diabetes on Metformin.BMC geriatrics · 2022Article
- The Risk Factors of Severe Hypoglycemia in Older Patients with Dementia and Type 2 Diabetes Mellitus.Journal of personalized medicine · 2022Article
2 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectiveOlder adults with diabetes and dementia are at increased risk for hypoglycemia and other adverse events associated with tight glycemic control and are unlikely to experience long-term benefits. We examined risk factors for tight glycemic control in this population and use of medications associated with a high risk of hypoglycemia in the subset with tight control. RESEARCH DESIGN AND
methodsThis retrospective cohort study of national Veterans Affairs (VA) administrative/clinical data and Medicare claims for fiscal years (FYs) 2008-2009 included 15,880 veterans aged ≥ 65 years with type 2 diabetes and dementia and prescribed antidiabetic medication. Multivariable regression analyses were used to identify sociodemographic and clinical predictors of hemoglobin A1c (HbA1c) control (tight, moderate, poor, or not monitored) and, in patients with tight control, subsequent use of medication associated with a high risk of hypoglycemia (sulfonylureas, insulin).
resultsFifty-two percent of patients had tight glycemic control (HbA1c <7% [53 mmol/mol]). Specific comorbidities, older age, and recent weight loss were associated with greater odds of tight versus moderate control, whereas Hispanic ethnicity and obesity were associated with lower odds of tight control. Among tightly controlled patients, 75% used sulfonylureas and/or insulin, with higher odds in patients who were male, black, or aged ≥ 75 years; had a hospital or nursing home stay in FY2008; or had congestive heart failure, renal failure, or peripheral vascular disease.
conclusionsMany older veterans with diabetes and dementia are at high risk for hypoglycemia associated with intense diabetes treatment and may be candidates for deintensification or alteration of diabetes medications.
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