ArticleJournal of the American Geriatrics Society2023
Glycemic control and diabetes complications across health status categories in older adults treated with insulin or insulin secretagogues: The Diabetes & Aging Study.
Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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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.
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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
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- Systematic review of guideline recommendations for older and frail adults with type 2 diabetes mellitus.Age and ageing · 2024Pooled it
- Preventing Severe Hypoglycemia in Type 2 Diabetes: Randomized Controlled Trial of Proactive Care With Versus Without Psychoeducation.Journal of general internal medicine · 2026Article
- Burden of Hypoglycemia and Hyperglycemia in Insulin-Treated Veterans Affairs Nursing Home Residents.Journal of the American Geriatrics Society · 2026Article
- Knowledge, perceptions and attitudes toward diabetes care in oncology: a pilot survey across specialties (DiaLog Study).Endocrine · 2026Article
- Real-world incidence and risk factors of level 3 (severe) hypoglycaemia in adults with type 1 or 2 diabetes (iNPHORM, United States).Diabetes, obesity & metabolism · 2026Article
- Associations of Co-Occurring Substance Use Disorder With Diabetes Care Quality, Complications, and Hospitalizations.Medical care · 2025Article
- Biases in the performance of FRAX without BMD in predicting fracture risk in a multiethnic population with diabetes: the Diabetes and Aging Study.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Article
- Individualized treatment of diabetes mellitus in older adults.Geriatrics & gerontology international · 2024Review
- Glycated Hemoglobin A1c Time in Range and Dementia in Older Adults With Diabetes.JAMA network open · 2024Article
- Control Level of Type 2 Diabetes Mellitus in the Elderly Is Associated with Polypharmacy, Accompanied Comorbidities, and Various Increased Risks According to the Beers Criteria.Diagnostics (Basel, Switzerland) · 2023Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundFor older adults with type 2 diabetes (T2D) treated with insulin or sulfonylureas, Endocrine Society guideline recommends HbA1c between 7% to <7.5% for those in good health, 7.5% to <8% for those in intermediate health, and 8% to <8.5% for those in poor health. Our aim was to examine associations between attained HbA1c below, within (reference), or above recommended target range and risk of complication or mortality.
methodsRetrospective cohort study of adults ≥65 years old with T2D treated with insulin or sulfonylureas from an integrated healthcare delivery system. Cox proportional hazards models of complications during 2019 were adjusted for sociodemographic and clinical variables. Primary outcome was a combined outcome of any microvascular or macrovascular event, severe hypoglycemia, or mortality during 12-month follow-up.
resultsAmong 63,429 patients (mean age: 74.2 years, 46.8% women), 8773 (13.8%) experienced a complication. Complication risk was significantly elevated for patients in good health (n = 16,895) whose HbA1c was above (HR 1.97, 95% CI 1.62-2.41) or below (HR 1.29, 95% CI 1.02-1.63) compared to within recommended range. Among those in intermediate health (n = 30,129), complication risk was increased for those whose HbA1c was above (HR 1.45, 95% CI 1.30-1.60) but not those below the recommended range (HR 0.99, 95% CI 0.89-1.09). Among those in poor health (n = 16,405), complication risk was not significantly different for those whose HbA1c was below (HR 0.98, 95% CI 0.89-1.09) or above (HR 0.96, 95% CI 0.88-1.06) recommended range.
conclusionsFor older adults with T2D in good health, HbA1c below or above the recommended range was associated with significantly elevated complication risk. However, for those in poor health, achieving specific HbA1c levels may not be helpful in reducing the risk of complications.
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