Diabetes care · 2025
Diabetes Overtreatment and Hypoglycemia in Older Patients With Type 2 Diabetes on Insulin Therapy: Insights From the HYPOAGE Cohort Study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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, Boureau Anne-Sophie, Guyomarch Béatrice, de Decker Laure, Boland Benoit, Hadjadj Samy, Cariou Bertrand, HYPOAGE Study Group
Аннотация
OBJECTIVE: To assess the accuracy of "diabetes overtreatment" proxy definitions in predicting hypoglycemia in older adults with type 2 diabetes (T2D).
RESEARCH DESIGN AND METHODS: Inclusion of patients from HYPOAGE cohort with insulin-treated T2D, aged ≥75 years, and using a continuous glycemic monitoring (CGM) device for 28 days. "Diabetes overtreatment" was defined as HbA1c <7.0% (fixed proxy definition) or as HbA1c <7.0%, 7.5%, and 8.0% according to patient's health status (individualized proxy definition). The primary outcome was time below range (TBR) ≥1%.
RESULTS: Of the 134 patients included (81.6 ± 5.4 years, 59% male), 25 (19%) and 53 (40%) were overtreated, based on fixed and individualized proxy definitions, respectively. CGM data showed TBR >1% in nearly all patients regardless of overtreatment status. Both proxy definitions had low sensitivity (20% [14; 29] and 41% [32; 50]) and accuracy (27% [20; 35] and 44% [35; 53]) in predicting hypoglycemia.
CONCLUSIONS: A revised definition of diabetes overtreatment is needed to better manage older insulin-treated patients and protect them from hypoglycemia.
RESEARCH DESIGN AND METHODS: Inclusion of patients from HYPOAGE cohort with insulin-treated T2D, aged ≥75 years, and using a continuous glycemic monitoring (CGM) device for 28 days. "Diabetes overtreatment" was defined as HbA1c <7.0% (fixed proxy definition) or as HbA1c <7.0%, 7.5%, and 8.0% according to patient's health status (individualized proxy definition). The primary outcome was time below range (TBR) ≥1%.
RESULTS: Of the 134 patients included (81.6 ± 5.4 years, 59% male), 25 (19%) and 53 (40%) were overtreated, based on fixed and individualized proxy definitions, respectively. CGM data showed TBR >1% in nearly all patients regardless of overtreatment status. Both proxy definitions had low sensitivity (20% [14; 29] and 41% [32; 50]) and accuracy (27% [20; 35] and 44% [35; 53]) in predicting hypoglycemia.
CONCLUSIONS: A revised definition of diabetes overtreatment is needed to better manage older insulin-treated patients and protect them from hypoglycemia.