Fördel minska diabetesbehandling hos svårt multisjuka med lågt HbA1c. Positiva resultat från utsättningsstudie bland äldre i särskilt boende
Engelsk titel: Benefit of reduced diabetes medication in elderly with severe multiple comorbidity and low HbA1c. Positive results from a drug withdrawal study among elderly in nursing homes
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Författare:
Östgren CJ
;
Sjöblom P
;
Tengblad A
;
Löfgren UB
;
Rosenqvist U
;
Mölstad S
Email: carl.johan.ostgren@liu.se
Språk: Swe
Antal referenser: 7
Dokumenttyp:
Artikel
UI-nummer: 09061903
Sammanfattning
Aim:To explore the feasibility of withdrawal of diabetes medication in elderly patients with HbA1c d 6.0%.
Methods: HbA1c was measured in 98 patients with known diabetes in 17 nursing homes in Sweden. 32 subjects with HbA1c d 6.0% participated in the drug withdrawal study. After measuring plasma glucose on three consecutive days, diabetes drugs were reduced, i.e. complete withdrawal of oral anti-diabetic drugs (OADs), complete insulin withdrawal when doses were d 20 units/day and reduced by half in patients on more than 20 units/day.
Results: We identified 31 episodes of plasma glucose d 4.4 mmol/l. Mean HbA1c was 5.2 % ± 0.4 compared to 7.1 % ± 1.6 in the non-intervention group. Three months after the diabetes drug discontinuation, 24 patients (75%) remained in the intervention group and mean HbA1c was then 5.8 %. ± 0.9 and after six months still unchanged: 5.8 % ± 1.1.
Conclusions: Hypoglycaemic events are common among elderly patients with type 2 diabetes. The withdrawal of diabetes medication in elderly with tight glycaemic control is safe and may decrease the risk for hypoglycaemia.