Effect of deprescribing in elderly patients with type 2 diabetes: iDegLira might improve quality of life - 13/11/21
pages | 6 |
Iconographies | 2 |
Vidéos | 0 |
Autres | 0 |
Abstract |
Older people with type 2 diabetes (T2D) often have several comorbidities and take multiple drugs. This study tested a deprescribing strategy in older T2D patients, replacing a hypoglycemic therapeutic scheme with a single drug combination (iDegLira). In this 6-month, real-world, single-arm, open interventional study, we enrolled patients ≥ 75 years with T2D taking ≥ 2 medications for diabetes. Patients on a basal-bolus insulin regimen (n = 13), on a basal-insulin regimen plus oral glucose-lowering drugs (n = 9), and those on oral glucose-lowering drugs (n = 18) were switched to daily iDegLira. The primary clinical endpoint of the study was an improvement in CASP-19 and/or DTSQ score after 6 months. We also evaluated changes in glucose metabolism, depression, cognitive function, level of independence, and markers of inflammation. Thirty-five patients (12 women, mean age=81.4 y) completed the protocol. Results shown here are given as estimated mean difference (95%CI). DTSQ score improved [11.08 (7.13/15.02); p = 0.0001], whereas CASP-19 did not after 6 months of iDegLira treatment. We observed reductions in BMI [− 0.81 (− 1.27/0.35); p < 0.001], fasting glucose [− 52.07 (− 77.26/26.88); p < 0.001], HbA1c [− 0.58 (− 1.08/0.08); p < 0.05], and TNF-α [− 1.83 (− 3.12/− 0.54); p = 0.007]. Activities of daily living and cognitive function score increased [p = 0.006 and p = 0.02], whereas depression score significantly decreased [p = 0.02]. Notably, no patient reported episodes of severe hypoglycemia after initiation of iDegLira treatment. Among older patients with T2D, deprescribing using a single dose of iDegLira resulted in a greater likelihood of improving health and quality of life. Although our data indicate the effectiveness and safety of this approach, it must be confirmed in larger studies.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | Older people with type 2 diabetes (T2D) take multiple drugs for several comorbidities, with a detrimental effect on quality of life (QoL). |
• | ·To reduce the high pill burden and improve QoL, we replaced the hypoglycemic therapy with a single dose of iDegLira in a group of older T2D patients. |
• | We observed a significant improving in level of independence, depression, cognitive function, a reduction in BMI, fasting glucose, HbA1c, TNF-α. |
• | No patient reported episodes of severe hypoglycemia after initiation of iDegLira. |
• | Although our data indicate the effectiveness and safety of this approach, it must be confirmed in larger studies. |
Keywords : Diabetes, Elderly, Deprescribing, Quality of life, IDegLira
Plan
Vol 144
Article 112341- décembre 2021 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’achat d’article à l’unité est indisponible à l’heure actuelle.
Déjà abonné à cette revue ?