Age and ageing · 2025
Association between hypoglycaemic drug de-intensification, mortality and hospital admission in older adults with type 2 diabetes: a cohort study emulating a target trial.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Christiaens Antoine, Cochard Alexis, Tubach Florence, Thompson Wade, Sinclair Alan J, Henrard Séverine, Boland Benoît, Slaouti-Jégou Yannis, Lekens Béranger, Bonnet-Zamponi Dominique, Simon-Tillaux Noémie, Zerah Lorene
Аннотация
BACKGROUND: Hypoglycaemic drugs (sulfonylureas, glinides or insulins) are commonly prescribed for older adults with type 2 diabetes (T2D) but may carry risks of adverse events. Whether de-intensifying hypoglycaemic drugs is associated with clinical benefit in older adults remains unknown.
OBJECTIVE: To evaluate the association between de-intensification of hypoglycaemic drugs and clinical outcomes in older adults with T2D.
METHODS: Cohort study conducted with the target trial emulation approach, using data collected from 2000 French general practises between January 2010 and February 2019 (The Health Improvement Network-THIN database). Eligible participants were ≥75 years old, on stable hypoglycaemic drugs (no change in drug or dose) for at least 6 months, and had an HbA1c value <9%. Hypoglycaemic drug de-intensification (exposure) was defined as cessation or reduction of ≥50% of total dose. The primary outcome was a composite measure of all-cause death or hospital admissions within 3 months, and its association with exposure was assessed using multivariable logistic regression adjusted for potential baseline confounders.
RESULTS: The study included 14 383 unique individuals corresponding to 177 314 trial emulation participants (mean age 80 years; 44.7% female). Of these, 6480 participants were allocated to de-intensification group, and 170 834 to the control group. At 3 months, the primary outcome occurred in 3.96% of the de-intensification group and 2.99% of controls [adjusted relative risk, 1.33 (95% CI, 1.22-1.43)]. Subgroup analyses showed consistent associations across most participants' profiles.
CONCLUSIONS: In older adults with T2D, de-intensification of hypoglycaemic drugs was associated with a higher short-term risk of all-cause death or hospitalisation.
OBJECTIVE: To evaluate the association between de-intensification of hypoglycaemic drugs and clinical outcomes in older adults with T2D.
METHODS: Cohort study conducted with the target trial emulation approach, using data collected from 2000 French general practises between January 2010 and February 2019 (The Health Improvement Network-THIN database). Eligible participants were ≥75 years old, on stable hypoglycaemic drugs (no change in drug or dose) for at least 6 months, and had an HbA1c value <9%. Hypoglycaemic drug de-intensification (exposure) was defined as cessation or reduction of ≥50% of total dose. The primary outcome was a composite measure of all-cause death or hospital admissions within 3 months, and its association with exposure was assessed using multivariable logistic regression adjusted for potential baseline confounders.
RESULTS: The study included 14 383 unique individuals corresponding to 177 314 trial emulation participants (mean age 80 years; 44.7% female). Of these, 6480 participants were allocated to de-intensification group, and 170 834 to the control group. At 3 months, the primary outcome occurred in 3.96% of the de-intensification group and 2.99% of controls [adjusted relative risk, 1.33 (95% CI, 1.22-1.43)]. Subgroup analyses showed consistent associations across most participants' profiles.
CONCLUSIONS: In older adults with T2D, de-intensification of hypoglycaemic drugs was associated with a higher short-term risk of all-cause death or hospitalisation.