ArticleJournal of the American Geriatrics Society2018
Use of Intensive Glycemic Management in Older Adults with Diabetes Mellitus.
Article in Journal of the American Geriatrics Society, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers.
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Who cites it
32 citing papers in PubMed, 73 citations in OpenAlex.
- Efficacy of telemedicine on glycaemic control in nursing home residents with type 2 diabetes on basal-bolus insulin therapy: A randomised controlled trial.Diabetes, obesity & metabolism · 2026Trial
- 13. Older Adults: Standards of Care in Diabetes-2026.Diabetes care · 2026Review
- Potential overtreatment in elderly patients with diabetes mellitus: Results from a cross-sectional study in German general practice.The European journal of general practice · 2025Article
- Realigning diabetes regimens in older adults: a 4S Pathway to guide simplification and deprescribing strategies.The lancet. Diabetes & endocrinology · 2025Review
- Deprescribing in Older Adults With Type 2 Diabetes: Associations With Patients' Perspectives: The Diabetes and Aging Study.Journal of the American Geriatrics Society · 2025Article
- 13. Older Adults: Standards of Care in Diabetes-2025.Diabetes care · 2025Review
- The Value of Glycemic Gap for Predicting Mortality in ICU in Patients With and Without Diabetes.Journal of diabetes research · 2025Article
- Decline in use of high-risk agents for tight glucose control among older adults with diabetes in New York City: 2017-2022.Journal of the American Geriatrics Society · 2024Article
- Association between glycaemic control and malnutrition in older adults with type 2 diabetes mellitus: a cross-sectional study.The British journal of nutrition · 2024Article
- 13. Older Adults: Standards of Care in Diabetes-2024.Diabetes care · 2024Review
- Glycemic and Economic Outcomes in Elderly Patients with Type 2 Diabetes Initiating Dulaglutide Versus Basal Insulin in a Real-World Setting in the United States: The DISPEL-Advance Study.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2023Article
- A Qualitative Study of Perspectives of Older Adults on Deintensifying Diabetes Medications.Journal of general internal medicine · 2023Article
- Association between diabetes overtreatment in older multimorbid patients and clinical outcomes: an ancillary European multicentre study.Age and ageing · 2023Article
- 13. Older Adults: Standards of Care in Diabetes-2023.Diabetes care · 2023Review
- Potential Risk of Overtreatment in Patients with Type 2 Diabetes Aged 75 Years or Older: Data from a Population Database in Catalonia, Spain.Journal of clinical medicine · 2022Article
- Initiating second-line antidiabetic medication among older adults with type 2 diabetes on Metformin.BMC geriatrics · 2022Article
- 13. Older Adults: Standards of Medical Care in Diabetes-2022.Diabetes care · 2022Review
- Using an Electronic Health Record and Deficit Accumulation to Pragmatically Identify Candidates for Optimal Prescribing in Patients With Type 2 Diabetes.Diabetes spectrum : a publication of the American Diabetes Association · 2022Article
- Effect of glycemic gap upon mortality in critically ill patients with diabetes.Journal of diabetes investigation · 2021Observational
- Factors associated with potential over- and undertreatment of hyperglycaemia and annual measurement of HbADiabetic medicine : a journal of the British Diabetic Association · 2021Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesTo examine the proportion of older adults with diabetes mellitus treated with tight glucose control and the factors associated with this practice.
designCross-sectional analysis.
settingOutpatient sites in the Diabetes Collaborative Registry (N=151).
participantsAdults aged 75 and older with type 2 diabetes mellitus (N=42,669). MEASUREMENTS: Participants were categorized based on glycosylated hemoglobin (HbA1c) and glucose-lowering medications: poor control (HbA1c >9%), moderate control (HbA1c 8-9%), conservative control (HbA1c 7-8%), tight control (HbA1c <7%) with low-risk agents (low risk for hypoglycemia), tight control with high-risk agents, and diet control (HbA1c <7% taking no glucose-lowering medications). We used hierarchical logistic regression to examine participant and site factors associated with tight control and high-risk agents versus conservative or tight control and low-risk agents.
resultsOf 30,696 participants without diet-controlled diabetes, 5,596 (18%) had moderate or poor control, 9,227 (30%) had conservative control, 7,893 (26%) had tight control taking low-risk agents, and 7,980 (26%) had tight control taking high-risk agents. Older age, male sex, heart failure, chronic kidney disease, and coronary artery disease were each independently associated with greater odds of tight control with high-risk agents. There were no differences according to practice specialty (endocrinology, primary care, cardiology) in how aggressively participants were managed.
conclusionOne-quarter of U.S. older adults with type 2 diabetes mellitus are tightly controlled with glucose-lowering medications that have a high risk of hypoglycemia. These results suggest potential overtreatment of a substantial proportion of people and should encourage further efforts to translate guidelines to daily practice.
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