Can diabetes medication be reduced in elderly patients?: An observational study of diabetes drug withdrawal in nursing home patients with tight glycaemic control
2008 (English)In: Diabetes Research and Clinical Practice, ISSN 0168-8227, E-ISSN 1872-8227, Vol. 82, no 2, 197-202 p.Article in journal (Refereed) Published
Aim: To explore the feasibility of withdrawal of diabetes medication in elderly patients with HbA1c £ 6.0%.
Methods: HbA1c was measured in 98 patients with known diabetes in 17 nursing homes in Sweden. 32 subjects with HbA1c £ 6.0% participated in the drug withdrawal study. After measuring plasma glucose on three consecutive days, diabetes drugs were reduced, i.e. complete withdrawal of oral anti-diabetic drugs (OADs), complete insulin withdrawal when doses were £ 20 units/day and reduced by half in patients on more than 20 units/day.
Results: We identified 31 episodes of plasma glucose £ 4.4 mmol/l, most of them nocturnal (n=17). Mean HbA1c was 5.2 % ± 0.4 compared to 7.1 % ± 1.6 in the non-intervention group. Three months after the diabetes drug discontinuation, 24 patients (75%) remained in the intervention group and mean HbA1c was then 5.8 %. ± 0.9. Six months after baseline investigation mean HbA1c in the intervention group was 5.8 % ± 1.1 compared with 6.6 % ± 1.4 in the non-intervention group.
Conclusions: Hypoglycaemic events are common among elderly patients with type 2 diabetes. The withdrawal of diabetes medication in elderly with tight glycaemic control is safe and may decrease the risk for hypoglycaemia.
Place, publisher, year, edition, pages
2008. Vol. 82, no 2, 197-202 p.
Diabetes, Drug therapy, Hypoglycaemia
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-16312DOI: 10.1016/j.diabres.2008.08.014OAI: oai:DiVA.org:liu-16312DiVA: diva2:133711
Original Publication: Peter Sjöblom, Anders Tengblad, Ulla-Britt Löfgren, Christina Lannering, Niklas Anderberg, Ulf Rosenqvist, Sigvard Mölstad and Carl J Östgren, Can diabetes medication be reduced in elderly patients?: An observational study of diabetes drug withdrawal in nursing home patients with tight glycaemic control, 2008, Diabetes Research and Clinical Practice, (82), 2, 197-202. http://dx.doi.org/10.1016/j.diabres.2008.08.014 Copyright: Elsevier Science B.V., Amsterdam. http://www.elsevier.com/2009-01-142009-01-142014-01-21Bibliographically approved