ArticleEGEMS (Washington, DC)2019
Age-Dependent Hemoglobin A1c Therapeutic Targets Reduce Diabetic Medication Changes in the Elderly.
Article in EGEMS (Washington, DC), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 8 citations in OpenAlex.
- The effect of oral magnesium supplementation on glycemic control and metabolic parameters in type 2 diabetes mellitus: a double-blind randomized controlled trial.Frontiers in endocrinology · 2026Trial
- Glycemic Control and Utilization Risk With the Conversion of Glimepiride to Glipizide in Adults 64 Years and Older at an Integrated Health Care System.Journal of the American Geriatrics Society · 2026Article
- Age-stratified associations of glycemia, blood pressure, and cholesterol with mortality in diabetes: A prospective cohort study.BMC medicine · 2026Article
- Differential Effects of Admission Hemoglobin AJournal of the American Heart Association · 2025Article
- When gender matters: inequalities in health services utilization and risk factors monitoring after acute myocardial infarction.Frontiers in global women's health · 2025Article
- Trends and Disparities in Glycemic Control and Severe Hyperglycemia Among US Adults With Diabetes Using Insulin, 1988-2020.JAMA network open · 2022Article
- Effects of colchicine use on ischemic and hemorrhagic stroke risk in diabetic patients with and without gout.Scientific reports · 2022Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess whether implementation of age-dependent therapeutic targets for high hemoglobin A1c (HbA1c) changed clinicians' ordering of diabetes medications for older adults.
backgroundIn 2016, Kaiser Permanente Southern California (KPSC) changed the therapeutic targets for alerting clinicians about high HbA1c results in the electronic health record, KP HealthConnect (KPHC). Previously, all HbA1c results ≥7.0 percent were flagged as high in adult patients with diabetes. Starting in 2016, HbA1c therapeutic targets were relaxed to <7.5 percent for patients age 65 to 75, and to <8.0 percent for patients over age 75 to reduce treatment intensity and adverse events.
methodsThis retrospective analysis used logistic regression models to calculate the change in odds of a medication change following an HbA1c result after age-dependent HbA1c flags were introduced.
resultsThe odds of medication change decreased among patients whose HbA1c targets were relaxed: Odds Ratio (OR) 0.72 (95 percent CI 0.67-0.76) for patients age 65-75 and HbA1c 7.0 percent-7.5 percent; OR 0.72 (95 percent CI 0.65-0.80) for patients over age 75 and HbA1c 7.0 percent-7.5 percent; and OR 0.67 (95 percent CI 0.61-0.75) for patients over age 75 and HbA1c 7.5 percent-8.0 percent. In the age and HbA1c ranges for which the alerts did not change, the odds of medication change generally increased or stayed the same. There was little evidence of medication de-intensification in any group.
conclusionsThese findings suggest that the change in therapeutic targets was associated with a reduction in medication intensification among older adults with diabetes.
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