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22-04-2012 | Diabetes | Article

Anti-diabetes therapy initiated earlier in younger than in older patients

Abstract

Free abstract

MedWire News: The proportion of UK patients with diabetes who begin antihyperglycemic medication within 2 years varies depending on how old they are when first diagnosed, report researchers.

Only 51% of newly diagnosed patients begin antihyperglycemic medication within 2 years, with older patients significantly less likely to be prescribed medication during this time.

Diabetes treatment guidelines recommend initiating the treatment either concomitantly with or following a brief period of lifestyle intervention. However, many newly diagnosed patients are not prescribed antihyperglycemics for extended periods of time despite confirmed inadequate glycemic control with lifestyle interventions, say Panagiotis Mavros (Merck Sharp & Dhome Corp, New Jersey, USA) and colleagues.

As reported in BMC Endocrine Disorders, the researchers assessed the association between patient age and initiation of antihyperglycemic medication following first diabetes diagnosis using data from the Intercontinental Medical Statistic MediPlus database.

The team identified 9158 newly diagnosed Type 2 diabetes patients during 2003 through 2005 using the International Classification of Disease (ICD)-10 codes.

The primary outcome was the proportion of patients who began antihyperglycemic medication during the 2-year period following the initial diagnosis. Data on the time-to-treatment initiation were assessed at 2 years of follow-up.

The researchers report that, overall, 36%, 42%, and 51% of patients initiated antihyperglycemic therapy within 180 days, 1 year, and 2 years, respectively.

The proportion of patients initiating treatment within 2 years of diagnosis decreased with advancing age, at 65%, 55%, 46%, and 40% for patients aged 30 to 44 years, 45 to 64 years, 65 to 74 years, and more than 75 years at first diabetes diagnosis, respectively.

The median time-to-treatment initiation increased with advancing age from 213 days to 530 days, and to over 730 days in patients with a first-diagnosis age of 30 to 44 years, 45 to 64 years, and 65 years or over, respectively.

Cox regression analysis revealed that increasing age was significantly and inversely associated with time-to-treatment initiation.

"It is apparent that older patients in this study were not treated as frequently with antihyperglycemic therapy as younger patients with the same HbA1c [glycated hemoglobin] level," say the researchers. "The results highlight the under-treatment of older adults with Type 2 diabetes."

The team says further research is needed to better understand the reasons for the observed differences between younger and older patients with Type 2 diabetes.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Sally Robertson