The Rates of Overtreatment and Deintensification in Patients With Diabetes Mellitus

The Rates of Overtreatment and Deintensification of Antidiabetic and Antihypertensive Medications in Patients With Diabetes Mellitus

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT03503045

Enrollment

1276

Registered

2018-04-19

Start date

2017-04-01

Completion date

2017-06-30

Last updated

2019-02-21

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Diabetes Mellitus

Keywords

Diabetes Mellitus, Polypharmacy, Overtreatment, Undertreatment

Brief summary

This study evaluates the overtreatment and deintensification rates of antidiabetic and antihypertensive medications in patients with diabetes mellitus in Turkey.

Detailed description

Diabetes mellitus is one of the most common chronic diseases which lead to serious public health problems and a significant economic burden worldwide. The prevalence of diabetes in elderly patients is very high and is predicted to increase dramatically. Prior studies have generally been concerned with the inadequate treatment of diabetes however, over the last few years the overtreatment of diabetes has also come to the fore. Unfortunately, there are very few data worldwide and no data in Turkey about the overtreatment of patients with type 2 diabetes. This study aimed to assess the rates and predictors of overtreatment and undertreatment of glycemia and blood pressure in older adults with T2DM. Treatment deintensification or intensification by the physicians were also investigated.

Interventions

None listed

Study design

Observational model

COHORT

Time perspective

CROSS_SECTIONAL

Eligibility

Sex/Gender

ALL

Age

65 Years to No maximum

Healthy volunteers

Inclusion criteria

* Patients with Diabetes Mellitus type I or II * Age 65 years or older * To be under follow-up in the same center for at least one year.

Exclusion criteria

* Younger than 65 years old * having decompensated liver disease * psychiatric disorders interfering cognition or compliance * having bariatric surgery or on renal replacement therapy

Design outcomes

Primary

Measure	Time frame	Description
Overtreatment for glycemia	7 days	HbA1c\<6.5% plus use of ≥2 oral hypoglycemics or insulin, except metformine.

Secondary

Measure	Time frame	Description
Undertreatment for glycemia	7 days	HbA1c\>9%
Overtreatment for blood pressure	7 days	systolic blood pressure \< 120 mmHg or diastolic blood pressure \< 65 mmHg and use of at least one drug additional to ACE inhibitors
Undertreatment for blood pressure	7 days	SBP≥140 mmHg or DPB ≥ 90 mmHg and use of two or less drugs
Deintensification of treatment	7 days	discontinuation or dosage decrease within 6 months after the index measurement.

Countries

Turkey (Türkiye)

Outcome results