Evidence map›Paper›PMID 39572394›Full record

SynthesisAge and ageing2024

Systematic review of guideline recommendations for older and frail adults with type 2 diabetes mellitus.

Jennifer Bolt, Valeria Carvalho, Kristine Lin, Sung Ju Lee, Colleen Inglis

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Age and ageing, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

22 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Article
  5. Identification of Patient Clusters with Distinct Disease Progression Patterns Utilizing a Nationwide Finnish Population with Type 2 Diabetes.Diabetes therapy : research, treatment and education of diabetes and related disorders · 2026
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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

5 authors.

Jennifer BoltInterior Health Authority-Pharmacy Services, Kelowna Community Health & Services Centre, 505 Doyle Ave, Kelowna, British Columbia V1Y 6V8, Canada.ORCID 0000-0001-7597-8036
Valeria CarvalhoFaculty of Pharmaceutical Sciences, The University of British Columbia-Vancouver Campus, Vancouver, British Columbia V6T 1Z4, Canada.
Kristine LinFaculty of Pharmaceutical Sciences, The University of British Columbia-Vancouver Campus, Vancouver, British Columbia V6T 1Z4, Canada.
Sung Ju LeeFaculty of Pharmaceutical Sciences, The University of British Columbia-Vancouver Campus, Vancouver, British Columbia V6T 1Z4, Canada.
Colleen InglisFaculty of Pharmaceutical Sciences, The University of British Columbia-Vancouver Campus, Vancouver, British Columbia V6T 1Z4, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe application of clinical practice guidelines (CPGs) across the spectrum of individuals living with diabetes can be challenging, particularly in older adults, where factors such as frailty and multimorbidity exacerbate the complexity of management.

objectiveThis systematic review aimed to explore the guidance provided within diabetes CPGs for management of individuals who are older and/or frail, including recommendations for haemoglobin A1C (HbA1c) target and pharmacotherapeutic management.

methodsA systematic search was completed in Medline and Embase to identify national or international type 2 diabetes CPGs published in the last 10 years. Data extracted included recommendations for HbA1c targets and pharmacotherapy in older and frail adults, frailty screening and deprescribing. Quality of included CPGs was appraised with the AGREE II tool.

resultsTwenty-three CPGs were included, within which older adults and frailty were discussed in 21 and 14 CPGs, respectively. Specific HbA1c targets for older and/or frail adults were provided by 15 CPGs, the majority of which suggested a strict target (<7.0%-7.5%) in healthier older adults and a more relaxed target (<8.0%-8.5%) in those who are frail or medically complex. Ten CPGs provided recommendations for insulin therapy and 16 provided recommendations for non-insulin antihyperglycaemic agents that were specific to older and/or frail populations, which primarily focused on minimising risk of hypoglycaemia.

conclusionMost diabetes CPGs recommend strict HbA1c targets in healthier older adults, with more relaxed targets in those living with frailty or medical complexity. However, significant variability exists in pharmacotherapy recommendations and there were proportionately less recommendations for individuals who are frail.

Indexed as

Diabetes Mellitus, Type 2Frail ElderlyGlycated HemoglobinHypoglycemic AgentsPractice Guidelines as TopicAgedAged, 80 and overAge FactorsFrailtyHumansGlycated Hemoglobinhemoglobin A1c protein, humanHypoglycemic Agentsageddiabetes mellitusfrailolder peoplepractice guidelinessystematic review

Identifiers

PMID39572394
PMCPMC11581819

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.