Evidence map›Paper›PMID 33491105›Full record

ArticleDiabetologia2021

Potential diabetes overtreatment and risk of adverse events among older adults in Ontario: a population-based study.

Iliana C Lega, Michael A Campitelli, Peter C Austin, Yingbo Na, Afshan Zahedi, Freda Leung, Catherine Yu, Susan E Bronskill, Paula A Rochon, Lorraine L Lipscombe

Open access · bronzeAbstract readHistorical Article
PubMed Publisher
In one paragraph

Article in Diabetologia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
5.3field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 39 citations in OpenAlex.

  1. Trial
  2. Article
  3. Minimising harms of tight glycaemic control in older patients with type 2 diabetes.African journal of primary health care & family medicine · 2024
    Article
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  8. Simplification of Complex Insulin Regimens with IdegLira in People with Type 2 Diabetes: Literature Review and Clinical Recommendations.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2023
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Iliana C LegaWomen's College Research Institute, Women's College Hospital, Toronto, ON, Canada. iliana.lega@wchospital.ca.ORCID https://orcid.org/0000-0003-4816-2589
Michael A CampitelliICES, Toronto, ON, Canada.
Peter C AustinICES, Toronto, ON, Canada.ORCID https://orcid.org/0000-0003-3337-233X
Yingbo NaWomen's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
Afshan ZahediWomen's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
Freda LeungScarborough and Rouge Hospital, Toronto, ON, Canada.
Catherine YuDivision of Endocrinology and Metabolism, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Susan E BronskillWomen's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
Paula A RochonWomen's College Research Institute, Women's College Hospital, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-5973-4151
Lorraine L LipscombeWomen's College Research Institute, Women's College Hospital, Toronto, ON, Canada.ORCID https://orcid.org/0000-0001-7412-7993
University of Toronto · CAWomen's College Hospital · CASt. Michael's Hospital · CAThe Scarborough Hospital · CA

Funding

CIHR 1018890
6 · The paper itself

Abstract

aims/hypothesisMore than 25% of older adults (age ≥75 years) have diabetes and may be at risk of adverse events related to treatment. The aim of this study was to assess the prevalence of intensive glycaemic control in this group, potential overtreatment among older adults and the impact of overtreatment on the risk of serious events.

methodsWe conducted a retrospective, population-based cohort study of community-dwelling older adults in Ontario using administrative data. Participants were ≥75 years of age with diagnosed diabetes treated with at least one anti-hyperglycaemic agent between 2014 and 2015. Individuals were categorised as having intensive or conservative glycaemic control (HbA

resultsAmong 108,620 older adults with diagnosed diabetes in Ontario, the mean (± SD) age was 80.6 (±4.5) years, 49.7% were female, and mean (± SD) diabetes duration was 13.7 (±6.3) years. Overall, 61% of individuals were treated to intensive glycaemic control and 21.6% were treated to intensive control using high-risk agents. Using inverse probability treatment weighting with propensity scores, intensive control with high-risk agents was associated with nearly 50% increased risk of the composite outcome compared with conservative glycaemic control with low-risk agents (RR 1.49, 95% CI 1.08, 2.05). CONCLUSIONS/

interpretationOur findings underscore the need to re-evaluate glycaemic targets in older adults and to reconsider the use of anti-hyperglycaemic medications that may lead to hypoglycaemia, especially in setting of intensive glycaemic control.

Indexed as

OvertreatmentAgedAged, 80 and overAge FactorsAgingCohort StudiesDiabetes Mellitus, Type 2Drug-Related Side Effects and Adverse ReactionsFemaleGlycemic ControlHistory, 21st CenturyHumansHypoglycemiaHypoglycemic AgentsMaleOntarioHypoglycemic AgentsDiabetes overtreatmentHealthcare deliveryHypoglycaemiaInsulin secretagoguesInsulin therapyIntensive glycaemic controlOlder adults

Identifiers

PMID33491105
OpenAlexW3123510151

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.