Abstracts of the 18th Congress of the European Geriatric Medicine Society : Live from London and Online, 28–30 September 2022
(2022) 18th Congress of the European Geriatric Medicine Society — Location: London, UK (28.September.2022)
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- Introduction: Overtreatment by glucose-lowering treatment (GLT) is frequent and harmful in older people with type 2 diabetes (T2D), making de-intensification of GLT essential. This systematic review aimed at comparing recommendations defining profiles of older patients to be targeted by de-intensification of GLT. Methods: Using a comprehensive search of the literature, we included all clinical practice guidelines (CPGs) providing recommendations for de-intensification of GLT in older patients (C 65 years), published in English, after 2015 and supported by European or North American scientific societies or expert groups were included. Of these, we extracted all recommendations defining profiles of patients to be targeted by de-intensification of GLT. Results: Five CPGs of good methodological quality were included, most of which were supported by North American scientific societies. They all recommend a list of different profiles of patients for whom de-intensification of GLT should be proposed, either because those patients have an important risk of hypoglycaemia (e.g. advanced age, severe glycaemic control, multiple co-morbidities, frequent hypoglycaemia), or because the benefit of GLT is uncertain (cognitive impairment, frailty, or patients at the end of life). There are important differences between CPGs, but they all recommend to de-intensify GLT in patients with cognitive impairment or frailty. The extracted recommendations were mainly expert opinion-based, explaining partly these differences between CPGs. Conclusion: Given the challenge of avoiding overtreatment in older patients with T2D, it is crucial to improve the quality of recommendations for de-intensification of GLT, and in particular the definition of patients to be targeted by de-intensification.
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Christiaens, A., Henrard, S., Bonnet-Zamponi, D., & Zerah, L. (2022). Abstracts of the 18th Congress of the European Geriatric Medicine Society : Live from London and Online, 28–30 September 2022. European Geriatric Medicine, 13(S1), 1-439. https://doi.org/10.1007/s41999-022-00711-8 (Original work published 2022)