Older adults with type 2 diabetes and multiple chronic conditions are using less high-risk medications to manage their diabetes, but 1 in 6 of them still didn’t have solid glycemic control, according to a study published July 9 in Journal of the American Geriatrics Society.
Data in the study came from the INSIGHT Clinical Research Network, which includes multiple academic healthcare systems including Albert Einstein School of Medicine/Montefiore Medical Center, Columbia University, New York-Presbyterian Hospital and Houston Methodist, to name a few. Investigators compared data on the same people from 2017 and 2022.
The team looked at data from 11,728 older adults aged 75 or up who had type 2 diabetes and at least one other chronic medical condition in 2017. The team also evaluated data from 15,196 of people meeting that criteria in 2022.
Researchers assessed good glycemic control, which was having HbA1c less than 7%, and evaluated people based on being on a high-risk agent such as insulin or insulin secretagogue. Participants were only from New York City.
The number of older adults with poor glycemic control went down nearly 19% over the five-year span (It was 19.4% in 2017 and 15.8% in 2022). There was a significant decrease in insulin and sulfonylurea use (insulin use was at 27.8% in 2017 and 24.3% in 2022) while sulfonylurea use was 29.4% in 2017 and 21.7% in 2022. There was an increase in people using GLP-1 agonists from 1.8% in 2017 to 11.4% in 2022 and SGLT-2 inhibitor use went up from 5.8% in 2017 to 25.1% in 2022.
Factors linked to poor glycemic control in 2022 included history of heart failure, chronic kidney disease, colorectal cancer, and acute myocardial infarction, the team noted.
The fact that data showed 1 in 6 patients in 2022 still had poor glycemic control shows clinicians and patients still need to optimize disease management, the authors wrote.
