PMID- 26015163 OWN - NLM STAT- MEDLINE DCOM- 20160322 LR - 20231111 IS - 1468-2834 (Electronic) IS - 0002-0729 (Print) IS - 0002-0729 (Linking) VI - 44 IP - 4 DP - 2015 Jul TI - Antidiabetic and cardiovascular drug utilisation in patients diagnosed with type 2 diabetes mellitus over the age of 80 years: a population-based cohort study. PG - 566-73 LID - 10.1093/ageing/afv065 [doi] AB - BACKGROUND: there is a lack of evidence to inform treatment recommendations for very old people with type 2 diabetes mellitus (T2DM). OBJECTIVE: to evaluate trends in antidiabetic and cardiovascular drug utilisation for patients developing T2DM over 80 years of age. METHODS: a population-based cohort was sampled from the UK Clinical Practice Research Datalink between 1990 and 2013. Eligible patients were those with T2DM diagnosed after the age of 80 years and prescribed antidiabetic drugs. RESULTS: twelve thousand eight hundred and eighty-one patients, with 61% of females, were included. From 1990 to 2013, use of sulphonylureas declined from 94 to 29%, while metformin use increased from 22 to 86%. Prescribing of antihypertensive drugs increased substantially from 46 to 77%, lipid-lowering drugs from 1 to 64%, antiplatelets from 34 to 47% and oral anticoagulants from 5 to 19%. Women were more frequently prescribed antihypertensive drugs (odds ratio 1.26, 95% confidence interval 1.17 to 1.37) but less prescribed antiplatelets (0.83, 0.78 to 0.89). Compared with those diagnosed with T2DM from 80 to 89 years (n = 11,467, 89%), patients diagnosed after the age of 90 years (n = 1,414, 11%) were less likely to be prescribed insulin (0.37, 0.24 to 0.58), metformin (0.67, 0.60 to 0.75), antihypertensive drugs (0.42, 0.38 to 0.48), lipid-lowering drugs (0.26, 0.23 to 0.30) and anticoagulants (0.55, 0.44 to 0.68). CONCLUSIONS: there have been major increases in the intensity of pharmacological management of patients diagnosed with T2DM over 80 years of age, but the effectiveness and safety of these interventions in very old people require further evaluation. CI - (c) The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com. FAU - Hamada, Shota AU - Hamada S AD - Department of Primary Care and Public Health Sciences, King's College London, London, UK. FAU - Gulliford, Martin C AU - Gulliford MC AD - Department of Primary Care and Public Health Sciences and National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust, King's College London, London, UK. LA - eng PT - Journal Article PT - Multicenter Study PT - Research Support, Non-U.S. Gov't DEP - 20150525 PL - England TA - Age Ageing JT - Age and ageing JID - 0375655 RN - 0 (Blood Glucose) RN - 0 (Cardiovascular Agents) RN - 0 (Hypoglycemic Agents) SB - IM MH - Aged, 80 and over MH - Blood Glucose/*metabolism MH - Cardiovascular Agents/*therapeutic use MH - Cardiovascular Diseases/complications/*drug therapy MH - Diabetes Mellitus, Type 2/complications/diagnosis/*drug therapy MH - *Drug Utilization MH - Female MH - Follow-Up Studies MH - Humans MH - Hypoglycemic Agents/*therapeutic use MH - Male MH - *Population Surveillance MH - Retrospective Studies PMC - PMC4476852 OTO - NOTNLM OT - 80 and over OT - aged OT - cardiovascular diseases OT - drug utilisation OT - older people OT - type 2 diabetes mellitus EDAT- 2015/05/28 06:00 MHDA- 2016/03/24 06:00 PMCR- 2016/07/01 CRDT- 2015/05/28 06:00 PHST- 2014/10/14 00:00 [received] PHST- 2015/05/05 00:00 [accepted] PHST- 2015/05/28 06:00 [entrez] PHST- 2015/05/28 06:00 [pubmed] PHST- 2016/03/24 06:00 [medline] PHST- 2016/07/01 00:00 [pmc-release] AID - afv065 [pii] AID - 10.1093/ageing/afv065 [doi] PST - ppublish SO - Age Ageing. 2015 Jul;44(4):566-73. doi: 10.1093/ageing/afv065. Epub 2015 May 25.