July - September 2019, Volume 15, Issue 3

Akin S, Boluk C, Ozgur Y, Aladag N, Gecmez G, Keskin O, Turk Boru U, Tasdemir M

Overtreatment and Hypoglycemia Prevalence in Geriatric Patients with Type-2 Diabetes in the Turkish Population

Acta Endo (Buc) 2019, 15 (3): 311-316
doi: 10.4183/aeb.2019.311

Objective. To determine the prevalence of overtreatment and hypoglycemia in Turkish type-2 diabetes patients and to identify the risk factors. Methods. Patients ≥ 65 years, having a minimum 5 years of type-2 diabetes, were included in the study. Patients’ body mass index, mean HbA1c level, disease onset and medications related with their co-morbidities were recorded. Over-treatment is defined as the use of non-metformin therapies despite having HbA1c levels < 7%. A history of hypoglycemia episodes in the last three months and patients’ home blood glucose measurements were recorded. Factors relating to hypoglycemia and over-treatment were analyzed. Results. After applying criteria, 755 patients were included in the study: 728 patients (96.4%) had at least one comorbidity. 257 patients (34%) were found to have HbA1c levels < 7%. 217 of them (84.4%) were using non-metformin therapies. 497 patients (65.8%) were using insulin. The overtreatment prevalence in the ≥ 65 years group was 28.7%. The over-treatment ratio in ≥ 80 years group was 28.2%. Hypoglycemia prevalence in the last three months was 23.3%. It was 22.7% for patients ≥ 80 years. Mean age, disease duration, body mass index, insulin usage and doses were found to be significantly different in over-treated patients compared to the others. Conclusions. This study showed that despite recent guidelines, there is still a considerable amount of overtreated geriatric patients who are at risk of hypoglycemia and related morbidity and mortality. Insulinization rate was high. Physicians should not avoid de-intensifying the treatment of geriatric patients who have multiple co-morbidities.

Keywords: diabetes, epidemiology, hypoglycemia, over-treatment, Turkey.

Correspondence: Yasemin Ozgur MD, “Dr. Lütfi” Kirdar Kartal Training and Research Hospital, Department of Internal Medicine, Cevizli Street, Istanbul, 34890, Turkey, E-mail: dryaseminozgur@gmail.com