PMID- 33068664
OWN - NLM
STAT- MEDLINE
DCOM- 20210201
LR  - 20210201
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 170
DP  - 2020 Dec
TI  - Deprescription in elderly patients with type 2 diabetes mellitus.
PG  - 108498
LID - S0168-8227(20)30752-X [pii]
LID - 10.1016/j.diabres.2020.108498 [doi]
AB  - AIMS: The Primary aim is to verify physicians' adherence to the 2016 Italian 
      diabetes guidelines therapeutic targets, and their habits on deprescription in 
      elderly persons with Type 2 Diabetes Mellitus (T2DM). Secondary aims are the 
      assessment of the potential impact of the targets' changes in 2018 Italian 
      guidelines, and the outcomes of deprescription in the management of T2DM. 
      METHODS: Observational retrospective cohort study, enrolling persons with T2DM, 
      aged > 75 years, who attended a visit throughout 2017, and a second visit 
      6 months later in our outpatient clinic. RESULTS: Of the 387 patients included, 
      336 (87, 8%) were on target, according to 2016 guidelines. Deprescription was 
      advisable in 62% of patients on target. Among those, 22% were deprescribed. In 
      patients undergoing deprescription, during the following 6 months, no severe 
      hypoglycemia occurred (versus 5 cases in the prior 6 months). Glycated Hemoglobin 
      (HbA1c) increased (p < 0.05) from 47.0 [41.7-51.0] to 53.0 [45.4-59.5] mmol/mol). 
      Applying to the sample the 2018 Italian Guidelines targets, 57.2% would have been 
      on target, 18.5% above, and 24.3% below (needing deprescription). CONCLUSION: In 
      our study, a minority of suitable patients received deprescription. 
      Deprescription led to a significant reduction in severe hypoglycemia rate, 
      whereas HbA1c remained on target in the majority of cases.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Silverii, Giovanni Antonio
AU  - Silverii GA
AD  - University of Florence, Viale Morgagni, 50 - 50134 Firenze, Italy. Electronic 
      address: antonio.silverii@gmail.com.
FAU - Caldini, Eleonora
AU  - Caldini E
AD  - University of Florence, Viale Morgagni, 50 - 50134 Firenze, Italy.
FAU - Dicembrini, Ilaria
AU  - Dicembrini I
AD  - University of Florence, Viale Morgagni, 50 - 50134 Firenze, Italy.
FAU - Pieri, Maria
AU  - Pieri M
AD  - Careggi Hospital, Diabetology Unit, Largo Brambilla, 3 - 50134 Firenze, Italy.
FAU - Monami, Matteo
AU  - Monami M
AD  - Careggi Hospital, Diabetology Unit, Largo Brambilla, 3 - 50134 Firenze, Italy.
FAU - Mannucci, Edoardo
AU  - Mannucci E
AD  - University of Florence, Viale Morgagni, 50 - 50134 Firenze, Italy.
LA  - eng
PT  - Journal Article
DEP - 20201015
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Aged
MH  - *Deprescriptions
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Female
MH  - Humans
MH  - Hypoglycemia/*drug therapy
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Male
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Deprescription
OT  - Diabetes management in the elderly
OT  - Diabetes therapy
OT  - Hypoglycemia
COIS- Declaration of Competing Interest The authors declare that they have no known 
      competing financial interests or personal relationships that could have appeared 
      to influence the work reported in this paper. Declaration of Competing Interest 
      The authors declare the following financial interests/personal relationships 
      which may be considered as potential competing interests: Eleonora Caldini and 
      Maria Pieri have nothing to disclose. Giovanni Antonio Silverii and Ilaria 
      Dicembrini have received speaking fees from Novonordisk. Matteo Monami has 
      received speaking fees from Astra Zeneca, Bristol Myers Squibb, 
      Boehringer-Ingelheim, Eli-Lilly, Merck, Novo Nordisk, Sanofi, and Novartis and 
      research grants from Bristol Myers Squibb; Edoardo Mannucci has received 
      consultancy fees from Merck and Novartis speaking fees from Astra Zeneca, Bristol 
      Myers Squibb, Boehringer-Ingelheim, Eli-Lilly, Merck, Novo Nordisk, Sanofi, and 
      Novartis and research grants from Merck, Novartis, and Takeda. This research was 
      performed independently of any funding, as part of the institutional activity of 
      the investigators. All procedures followed were in accordance with the ethical 
      standards of the responsible committee on human experimentation (institutional 
      and national) and with the Helsinki Declaration of 1975, as revised in 2008.
EDAT- 2020/10/18 06:00
MHDA- 2021/02/02 06:00
CRDT- 2020/10/17 20:08
PHST- 2020/04/05 00:00 [received]
PHST- 2020/08/29 00:00 [revised]
PHST- 2020/10/05 00:00 [accepted]
PHST- 2020/10/18 06:00 [pubmed]
PHST- 2021/02/02 06:00 [medline]
PHST- 2020/10/17 20:08 [entrez]
AID - S0168-8227(20)30752-X [pii]
AID - 10.1016/j.diabres.2020.108498 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2020 Dec;170:108498. doi: 10.1016/j.diabres.2020.108498. 
      Epub 2020 Oct 15.