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Evaluation of Type 2 Diabetes Mellitus Medication Management and Control in Older Adults

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Objectives: The primary aims of this study were to characterize glycemic control and pharmacologic management in older patients and to compare glycemic control and pharmacological management in patients 65 to 79 years of age (“young-old”) with those 80 to 89 years of age (“old-old”). We hypothesized that patients 80 to 89 years of age would be prescribed fewer medications and would have higher A1c values compared with younger patients. Design: Retrospective medical record review. Setting: This study was conducted in outpatient clinics within a university hospital setting. Patients, Participants: This study included 400 adults 65 to 89 years of age with a diagnosis of type 2 diabetes mellitus and at least one A1c measurement over 12 months. Main Outcome Measures: A1c measurements and diabetes mellitus medications were assessed in these patients. Results: The overall mean A1c was similar in the young-old compared with the old-old (7.1 ± 1.1% vs. 7.0 ± 1.1%; P = NS). There was no difference between groups for any of the A1c ranges studied. Fewer diabetes medications were prescribed in the old-old compared with the young-old (P = 0.003). In the young-old compared with the old-old, metformin (51.0% vs. 33.0%; P < 0.01), glucagon-like peptide-1 agonists (6.7% vs. 0%; P < 0.01), insulin glargine/detemir (24.7% vs. 13.0%; P < 0.05), and short-acting insulin (15.0% vs. 7.0%; P < 0.05) were more frequently prescribed. Conclusion: Our results indicate that glycemic control was similar between the young-old and old-old. However, the old-old required fewer diabetic medications for this same level of glycemic control.
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Keywords: ACE = Angiotensin-converting enzyme; ARB = Angiotensin-receptor blocker; BP = Blood pressure; BUN = Blood urea nitrogen; DBP = Diastolic blood pressure; HTN = Hypertension; Hypertension; Hypotension; ISH = Isolated systolic hypertension; PSC = Pharmacy services clinic; Resistant hypertension; SBP = Systolic blood pressure; T2DM = Type 2 diabetes mellitus

Document Type: Research Article

Publication date: 2013-05-01

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  • The Consultant Pharmacist® is the official peer-reviewed journal of the American Society of Consultant Pharmacists. It is dedicated exclusively to the medication needs of the elderly in all settings, including adult day care, ambulatory care, assisted living, community, hospice, and nursing facilities. This award-winning journal is a member benefit of ASCP. Individuals who are not members and wish to receive The Consultant Pharmacist® will want to consider joining ASCP.
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