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16-11-2011 | Diabetes | Article

Over-65s wait longer to start antidiabetic therapy


Free abstract

MedWire News: Older patients with newly diagnosed Type 2 diabetes have to wait longer than younger people before receiving glucose-lowering treatment, study findings show.

People aged 65 years or more often have to wait 2 years or more after diagnosis before receiving oral antihyperglycemic agents (OAAs), report researchers in the journal Diabetes, Obesity and Metabolism.

Led by Qiaoyi Zhang (Merck Sharp & Dohme Corp., New Jersey, USA), the researchers used a medical record database to identify 10,743 patients who had been newly diagnosed with diabetes between January 2003 and December 2005.

They evaluated the length of time between the diagnosis of diabetes and the date of the first prescription for OAAs in younger (<65 years) and older (≥65 years) patients over a 2-year follow-up period.

The mean age at diagnosis was 52 years among the younger patients and 73 years among those categorized as older.

Analysis revealed that the median time to starting treatment was 350 days for younger patients compared with more than 2 years for older patients (of whom less than 50% had begun treatment by the end of follow-up).

The proportion of patients initiating treatment over the 2 years significantly declined as age at diagnosis increased, from 67% among those aged 33 to 44 years to 40% in those aged 75 years or more.

"There may, however, be valid reasons for physicians to view treatment of older patients with OAAs differently than treatment of younger patients," write Zhang and team.

A UK survey of general practitioners (GPs) found that the most common reason for nontreatment of either older or younger patients was the presence of mild hyperglycemia, write the researchers.

However, "GPs more often selected reasons related to safety issues (eg, risk of side effects or drug-drug interactions) and cognitive or physical function for the nontreatment of their older patients," they say.

"Barriers to initiating treatment of hyperglycemia in patients aged 65 years or more should be further investigated," concludes the team.

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By Sally Robertson