Evidence map›Paper›PMID 36626323›Full record

ArticleAge and ageing2023

Association between diabetes overtreatment in older multimorbid patients and clinical outcomes: an ancillary European multicentre study.

Antoine Christiaens, Oliver Baretella, Cinzia Del Giovane, Nicolas Rodondi, Wilma Knol, Mike Peters, Emma Jennings, Denis O'Mahony, Anne Spinewine, Benoit Boland and 1 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Age and ageing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
3.6field-weighted citation impact, top 6% 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, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

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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

11 authors at 6 institutions in 5 countries.

Antoine ChristiaensFonds de la Recherche Scientifique (FNRS), Brussels, Belgium.ORCID 0000-0002-4132-7769
Oliver BaretellaDepartment of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
Cinzia Del GiovaneInstitute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
Nicolas RodondiDepartment of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland.
Wilma KnolDepartment of Geriatrics and Expertise Centre Pharmacotherapy in Old Persons (EPHOR), UMC Utrecht, Utrecht, the Netherlands.
Mike PetersDepartment of Geriatrics and Expertise Centre Pharmacotherapy in Old Persons (EPHOR), UMC Utrecht, Utrecht, the Netherlands.
Emma JenningsDepartment of Medicine Cork, University College Cork National University of Ireland, Munster, IE, Republic of Ireland.
Denis O'MahonyDepartment of Medicine Cork, University College Cork National University of Ireland, Munster, IE, Republic of Ireland.
Anne SpinewineClinical Pharmacy Research Group, Louvain Drug Research Institute (LDRI), Université catholique de Louvain, Brussels, Belgium.
Benoit BolandInstitute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium.
Séverine HenrardClinical Pharmacy Research Group, Louvain Drug Research Institute (LDRI), Université catholique de Louvain, Brussels, Belgium.
University of Bern · CHNational University of Ireland · IEUCLouvain · BEUniversity Medical Center Utrecht · NLCliniques Universitaires Saint-Luc · BEInserm · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiabetes overtreatment is a frequent and severe issue in multimorbid older patients with type 2 diabetes (T2D).

objectiveThis study aimed at assessing the association between diabetes overtreatment and 1-year functional decline, hospitalisation and mortality in older inpatients with multimorbidity and polypharmacy.

methodsAncillary study of the European multicentre OPERAM project on multimorbid patients aged ≥70 years with T2D and glucose-lowering treatment (GLT). Diabetes overtreatment was defined according to the 2019 Endocrine Society guideline using HbA1c target range individualised according to the patient's overall health status and the use of GLT with a high risk of hypoglycaemia. Multivariable regressions were used to assess the association between diabetes overtreatment and the three outcomes.

resultsAmong the 490 patients with T2D on GLT (median age: 78 years; 38% female), 168 (34.3%) had diabetes overtreatment. In patients with diabetes overtreatment as compared with those not overtreated, there was no difference in functional decline (29.3% vs 38.0%, P = 0.088) nor hospitalisation rates (107.3 vs 125.8/100 p-y, P = 0.115) but there was a higher mortality rate (32.8 vs 21.4/100 p-y, P = 0.033). In multivariable analyses, diabetes overtreatment was not associated with functional decline nor hospitalisation (hazard ratio, HR [95%CI]: 0.80 [0.63; 1.02]) but was associated with a higher mortality rate (HR [95%CI]: 1.64 [1.06; 2.52]).

conclusionsDiabetes overtreatment was associated with a higher mortality rate but not with hospitalisation or functional decline. Interventional studies should be undertaken to test the effect of de-intensifying GLT on clinical outcomes in overtreated patients.

Indexed as

Diabetes Mellitus, Type 2HypoglycemiaAgedFemaleHumansMaleMultimorbidityPolypharmacydiabetes overtreatmentglucose-lowering treatmentmultimorbidityolder patientsolder peopletype 2 diabetes

Identifiers

PMID36626323
PMCPMC9831262
OpenAlexW4314446239

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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.