Polypharmacy in elderly patients with type 2 diabetes receiving oral antidiabetic treatment

• Published in: Acta diabetologica Vol. 53; no. 2; pp. 323 - 330
• Main Authors: Noale, Marianna, Veronese, Nicola, Cavallo Perin, Paolo, Pilotto, Alberto, Tiengo, Antonio, Crepaldi, Gaetano, Maggi, Stefania
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.04.2016; Springer Nature B.V
• Subjects: Age Factors; Aged; Aged, 80 and over; Cross-Sectional Studies; Diabetes; Diabetes Complications - epidemiology; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Drug therapy; Female; Health Care Surveys; Humans; Hypoglycemic Agents - administration & dosage; Hypoglycemic Agents - therapeutic use; Internal Medicine; Italy - epidemiology; Male; Medicine; Medicine & Public Health; Metabolic Diseases; Older people; Original Article; Polypharmacy; Prognosis; Sex Factors; Studies; Surveys and Questionnaires; Older patients; Polypharmacy; Type 2 diabetes mellitus; METABOLIC Study
• ISSN: 0940-5429; 1432-5233
• DOI: 10.1007/s00592-015-0790-4

Aim Polypharmacy in older diabetics can have detrimental effects linked to poor adherence and the risk of drug interaction or more serious/frequent side effects. The aim of this study was to identify the characteristics associated with polypharmacy in a cohort of elderly diabetic patients being treated with oral hypoglycemic agents. Methods The study population consisted of 1342 diabetic patients consecutively enrolled in 57 diabetes centers in Italy participating in the METABOLIC Study. Patients meeting the following inclusion criteria were enrolled: diagnosis of type 2 diabetes mellitus, age ≥65 years, and receiving oral antidiabetic treatment. Data concerning diabetes duration and complications, the medications the patients were taking, and the number of hypoglycemic events were registered. Multidimensional impairment was assessed using the Multidimensional Prognostic Index. Results The mean age of the participants was 73.3 ± 5.5 years. Polypharmacy, defined as being prescribed contemporaneously at least five drugs, was found in 57.1 % of the study population. According to a multivariable logistic model, the female gender was significantly associated with polypharmacy, as were living in Northern Italian regions, diabetes duration longer than 4 years, and having a body mass index ≥30 kg/m 2 . Comorbidities, diabetes complications, a better cognitive performance on the Short Portable Mental Status Questionnaire, and being malnourished/at risk of malnourishment according to the mini nutritional assessment were associated with polypharmacy. Conclusions Polypharmacy, a condition that may lead to many potential detrimental outcomes in older diabetic subjects, was significantly associated with some risk factors that may be useful to identify subjects at risk.