Older adults with T2D less likely to receive newer, safer medications

  • Pilla SJ & al.
  • J Am Geriatr Soc
  • 31 Jan 2019

  • curated by Miriam Tucker
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Older adults with type 2 diabetes (T2D) are less likely than younger adults to receive newer glucose-lowering medications, and increasingly are being prescribed long-acting insulin.  

Why this matters

  • Guidelines recommend avoiding medications with high hypoglycemic risk in older adults.  

Study design

  • Comparison of T2D treatment data from the National Ambulatory Medical Care Survey (NAMCS) for 25.4 and 24.2 million annual visits for adults aged ≥65 and 30-64 years, respectively, for 2006-2015.  
  • Funding: NIH.

Key results

  • During 2014-2015, older vs younger adults had:
    • greater use of long-acting insulin: 30.2% vs 22.4% of visits (P=.017).
  •  They had less use of: 
    • metformin: 56.0% vs 70.0% (P<.001>
    • glucagon-like peptide-1 receptor agonists: 2.9% vs 6.2% (P=.004).
  • Use of any insulin or sulfonylurea was greater in older vs younger adult visits:
    • 65.3% vs 54.8% (P=.016).
  • From 2010-2011 onward, insulin use rose from 25.3% to 39.0% of older adult visits (P-trend<.001 and long-acting insulin use rose from to>
  • In younger adult visits, use of any insulin was stable (33.8% to 33.0%; P-trend=.87) and long-acting insulin increased modestly (17.2% to 22.4%; P-trend=.081).

Limitations

  • Data represent visits, not patients.
  • Possible misclassification of diabetes type.
  • NAMCS increased the number of listable medications during survey period.

Please confirm your acceptance

To gain full access to GPnotebook please confirm:

By submitting here you confirm that you have accepted Terms of Use and Privacy Policy of GPnotebook.

Submit