Potential diabetes overtreatment and risk of adverse events among older adults in Ontario: A population-based study
Open accessAbstract
Aims/hypothesis More than 25% of older adults (age ≥75 years) have diabetes and may be at risk of adverse events related to treatment. The aim of this study was to assess the prevalence of intensive glycaemic control in this group, potential overtreatment among older adults and the impact of overtreatment on the risk of serious events.Methods We conducted a retrospective, population-based cohort study of community-dwelling older adults in Ontario using administrative data. Participants were ≥75 years of age with diagnosed diabetes treated with at least one anti-hyperglycaemic agent between 2014 and 2015. Individuals were categorised as having intensive or conservative glycaemic control (HbA 1c <53 mmol/mol [<7%] or 54-69 mmol/mol [7.1-8.5%], respectively), and as undergoing treatment with high-risk (i.e. insulin, sulfonylureas) or low-risk (other) agents. We measured the composite risk of emergency department visits, hospitalisations, or death within 30 days of reaching intensive glycaemic control with high-risk agents.Results Among 108,620 older adults with diagnosed diabetes in Ontario, the mean (± SD) age was 80.6 (±4.5) years, 49.7% were female, and mean (± SD) diabetes duration was 13.7 (±6.3) years. Overall, 61% of individuals were treated to intensive glycaemic control and 21.6% were treated to intensive control using high-risk agents. Using inverse probability treatment weighting with propensity scores, intensive control with high-risk agents was associated with nearly 50% increased risk of the composite outcome compared with conservative glycaemic control with low-risk agents (RR 1.49, 95% CI 1.08, 2.05).Conclusions/interpretation Our findings underscore the need to re-evaluate glycaemic targets in older adults and to reconsider the use of anti-hyperglycaemic medications that may lead to hypoglycaemia, especially in setting of intensive glycaemic control.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Wild, S., Roglic, G., Green, A., Sicree, R., & King, H. (2004) · Diabetes Care · doi:10.2337/diacare.27.5.1047 · Cited by 15,297 · see citing works
Austin, P. C. (2011) · Multivariate Behavioral Research · doi:10.1080/00273171.2011.568786 · Cited by 12,242 · see citing works
Self-citationIntensive blood glucose control and vascular outcomes in patients with type 2 diabetes
(2008) · New England Journal of Medicine · doi:10.1056/nejmoa0802987 · Cited by 7,397 · see citing works
Glucose control and vascular complications in veterans with type 2 diabetes
Duckworth, W., Abraira, C., Moritz, T., Reda, D., Emanuele, N., Reaven, P. D., Zieve, F. J., Marks, J., Davis, S. N., Hayward, R., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0808431 · Cited by 4,762 · see citing works
Austin, P. C., & Stuart, E. A. (2015) · Statistics in Medicine · doi:10.1002/sim.6607 · Cited by 4,495 · see citing works
Self-citationEmergency hospitalizations for adverse drug events in older Americans.
Budnitz, D., Lovegrove, M., Shehab, N., & Richards, C. (2011) · New England Journal of Medicine · doi:10.1056/nejmsa1103053 · Cited by 1,748 · see citing works
Hux, J. E., Ivis, F. J., Flintoft, V. F., & Bica, A. (2002) · Diabetes Care · doi:10.2337/diacare.25.3.512 · Cited by 1,290 · see citing works
Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus
Whitmer, R. A. (2009) · JAMA · doi:10.1001/jama.2009.460 · Cited by 1,128 · see citing works
Long-term effects of intensive glucose lowering on cardiovascular outcomes
The ACCORD Study Group (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1006524 · Cited by 1,035 · see citing works
Bonds, D. E., Miller, M. E., Bergenstal, R. M., Buse, J. B., Byington, R. P., Cutler, J. A., Dudl, R. J., Ismail-Beigi, F., Kimel, A. R., Hoogwerf, B., et al. (2010) · BMJ · doi:10.1136/bmj.b4909 · Cited by 933 · cited 1× · see citing works
“While previous studies have shown an increased risk of severe hypoglycaemia with intensive control [14, 24, 25], few have focused on the risk of high-risk agents in the setting of intensive glycaemic control.”
Follow-up of glycemic control and cardiovascular outcomes in type 2 diabetes
Hayward, R. A., Reaven, P. D., Wiitala, W. L., Bahn, G. D., Reda, D. J., Ge, L., McCarren, M., Duckworth, W. C., & Emanuele, N. V. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1414266 · Cited by 668 · see citing works
Lipscombe, L. L., & Hux, J. E. (2007) · The Lancet · doi:10.1016/s0140-6736(07)60361-4 · Cited by 628 · see citing works
Self-citationFollow-up of blood-pressure lowering and glucose control in type 2 diabetes
Zoungas, S., Chalmers, J., Neal, B., Billot, L., Li, Q., Hirakawa, Y., Arima, H., Monaghan, H., Joshi, R., Colagiuri, S., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1407963 · Cited by 626 · see citing works
Treatment of Diabetes in Older Adults: An Endocrine Society* Clinical Practice Guideline
LeRoith, D., Biessels, G. J., Braithwaite, S. S., Casanueva, F. F., Draznin, B., Halter, J. B., Hirsch, I. B., McDonnell, M. E., Molitch, M. E., Murad, M. H., et al. (2019) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2019-00198 · Cited by 586 · see citing works
Goto, A., Arah, O. A., Goto, M., Terauchi, Y., & Noda, M. (2013) · BMJ · doi:10.1136/bmj.f4533 · Cited by 492 · see citing works
Schultz, S., Rothwell, D., Chen, Z., & Tu, K. (2013) · Chronic diseases and injuries in Canada · doi:10.24095/hpcdp.33.3.06 · Cited by 449 · see citing works
Bolli, G., Feo, P. D., Compagnucci, P., Cartechini, M. G., Angeletti, G., Santeusanio, F., Brunetti, P., & Gerich, J. E. (1983) · Diabetes · doi:10.2337/diab.32.2.134 · Cited by 433 · see citing works
Potential overtreatment of diabetes mellitus in older adults with tight glycemic control
Lipska, K. J., Ross, J. S., Miao, Y., Shah, N. D., Lee, S. J., & Steinman, M. A. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2014.7345 · Cited by 408 · cited 3× · see citing works
“ties, despite these groups being at the highest risk of hypoglycaemia and least likely to benefit from intensive glycaemic targets [8, 42].”
BackgroundGodolphin, W. J. (2009) · Healthcare Quarterly · doi:10.12927/hcq.2009.20947 · Cited by 356 · see citing works
Khunti, K., Davies, M., Majeed, A., Thorsted, B. L., Wolden, M. L., & Paul, S. K. (2015) · Diabetes Care · doi:10.2337/dc14-0920 · Cited by 356 · see citing works
Thiazolidinediones and Cardiovascular Outcomes in Older Patients With Diabetes
Lipscombe, L. L., Gomes, T., Lévesque, L. E., Hux, J. E., Juurlink, D. N., & Alter, D. A. (2007) · JAMA · doi:10.1001/jama.298.22.2634 · Cited by 345 · see citing works
Self-citationPolypharmacy in the Aging Patient: A Review of Glycemic Control in Older Adults With Type 2 Diabetes
Lipska, K. J., Krumholz, H., Soones, T., & Lee, S. J. (2016) · JAMA · doi:10.1001/jama.2016.0299 · Cited by 309 · see citing works
A Systematic Review and Meta-Analysis of Hypoglycemia and Cardiovascular Events
Gangji, A. S., Cukierman, T., Gerstein, H. C., Goldsmith, C. H., & Clase, C. M. (2007) · Diabetes Care · doi:10.2337/dc06-1789 · Cited by 308 · see citing works
Jaakkimainen, R. L., Bronskill, S. E., Tierney, M. C., Herrmann, N., Green, D., Young, J., Ivers, N., Butt, D., Widdifield, J., & Tu, K. (2016) · Journal of Alzheimer's Disease · doi:10.3233/jad-160105 · Cited by 305 · see citing works
Self-citation12. Older Adults: Standards of Medical Care in Diabetes—2019
American Diabetes Association (2018) · Diabetes Care · doi:10.2337/dc19-s012 · Cited by 217 · see citing works
Inadequate vitamin D status: does it contribute to the disorders comprising syndrome ‘X’?
Boucher, B. J. (1998) · British Journal Of Nutrition · doi:10.1079/bjn19980055 · Cited by 213 · see citing works
Reid, R. J., Roos, N. P., MacWilliam, L., Frohlich, N., & Black, C. (2002) · Health Services Research · doi:10.1111/1475-6773.01029 · Cited by 212 · see citing works
Secular Changes in the Age-Specific Prevalence of Diabetes Among U.S. Adults: 1988–2010
Cheng, Y. J., Imperatore, G., Geiss, L. S., Wang, J., Saydah, S., Cowie, C. C., & Gregg, E. W. (2013) · Diabetes Care · doi:10.2337/dc12-2074 · Cited by 180 · see citing works
Assessing Potential Glycemic Overtreatment in Persons at Hypoglycemic Risk
Tseng, C., Soroka, O., Maney, M., Aron, D. C., & POGACH, L. M. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.12963 · Cited by 161 · see citing works
Intensive treatment and severe hypoglycemia among adults with type 2 diabetes
McCoy, R. G., Lipska, K. J., Yao, X., Ross, J. S., Montori, V. M., & Shah, N. D. (2016) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2016.2275 · Cited by 143 · see citing works
Hubbard, R. E., Andrew, M. K., Fallah, N., & Rockwood, K. J. (2010) · Diabetic Medicine · doi:10.1111/j.1464-5491.2010.02977.x · Cited by 132 · see citing works
Signorovitch, J. E., Macaulay, D., Diener, M., Yan, Y., Wu, E. Q., Gruenberger, J. ‐., & Frier, B. M. (2013) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.12031 · Cited by 125 · see citing works
Meneilly, G. S., Knip, A., Miller, D. B., Sherifali, D., Tessier, D., & Zahedi, A. (2018) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2017.10.021 · Cited by 118 · see citing works
Self-citationTam, D. Y., Dharma, C., Rocha, R. V., Farkouh, M. E., Abdel-Qadir, H. M., Sun, L. Y., Wijeysundera, H. C., Austin, P. C., Udell, J. A., Gaudino, M. F. L., et al. (2020) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2020.06.052 · Cited by 86 · see citing works
Self-citationMeneilly, G. S., Knip, A., & Tessier, D. (2013) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2013.01.045 · Cited by 81 · see citing works
Mitchell, A. P., Harrison, M. R., Walker, M. S., George, D. J., Abernethy, A. P., & Hirsch, B. R. (2015) · Journal of Oncology Practice · doi:10.1200/jop.2015.004929 · Cited by 81 · see citing works
Use of intensive glycemic management in older adults with diabetes mellitus
Arnold, S. V., Lipska, K. J., Wang, J., Seman, L., Mehta, S. N., & Kosiborod, M. (2018) · Journal of the American Geriatrics Society · doi:10.1111/jgs.15335 · Cited by 74 · see citing works
Hambling, C. E., Seidu, S., Davies, M. J., & Khunti, K. K. (2017) · Diabetic Medicine · doi:10.1111/dme.13380 · Cited by 63 · see citing works
Exploring reasons for very poor glycaemic control in patients with Type 2 diabetes
Khan, H., Lasker, S. S., & Chowdhury, T. A. (2011) · Primary care diabetes · doi:10.1016/j.pcd.2011.07.001 · Cited by 58 · see citing works
Singh, A. K., Kushwaha, P. P., Prajapati, K. S., Shuaib, M., Gupta, S., & Kumar, S. (2021) · Computers in Biology and Medicine · doi:10.1016/j.compbiomed.2020.104185 · Cited by 58 · see citing works
Population Trends in All‐Cause Mortality and Cause Specific–Death With Incident Atrial Fibrillation
Singh, S. M., Abdel-Qadir, H. M., Pang, A., Fang, J., Koh, M., Dorian, P., Wijeysundera, H. C., & Ko, D. T. (2020) · Journal of the American Heart Association · doi:10.1161/jaha.120.016810 · Cited by 51 · see citing works
Muller, N., Khunti, K. K., Kuß, O., Lindblad, U., Nolan, J. J., Rutten, G. E. H. M., Trento, M., Porta, M., Roth, J., Charpentier, G., et al. (2016) · Acta Diabetologica · doi:10.1007/s00592-016-0939-9 · Cited by 44 · see citing works
Appropriate Prescribing for Patients With Diabetes at High Risk for Hypoglycemia
Caverly, T. J., Fagerlin, A., Zikmund‐Fisher, B. J., Kirsh, S. R., Kullgren, J. T., Prenovost, K. M., & Kerr, E. A. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2015.5950 · Cited by 39 · see citing works
Yu, C. H. Y., Lillie, E., Johnson, A. M., Casey, C. G., & Straus, S. E. (2018) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2018.02.041 · Cited by 30 · see citing works
Self-citationYu, A., Austin, P. C., Rashid, M. K., Fang, J., Porter, J., Hill, M. D., & Kapral, M. K. (2020) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.119.006269 · Cited by 26 · see citing works
Self-citationSevere Hypoglycemia Attributable to Intensive Glucose-Lowering Therapy Among US Adults With Diabetes
Mahoney, G. K., Henk, H. J., & McCoy, R. G. (2019) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2019.02.028 · Cited by 21 · see citing works
An Examination of Deintensification Recommendations in Clinical Practice Guidelines
Markovitz, A. A., Hofer, T. P., Froehlich, W., Lohman, S. E., Caverly, T. J., Sussman, J. B., & Kerr, E. A. (2017) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2017.7198 · Cited by 20 · see citing works
Yu, C. H. Y., Casey, C. G., Ke, C., Lebovic, G., & Straus, S. E. (2018) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2018.08.189 · Cited by 15 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Less is More: Deprescribing Medications in Older Adults with Kidney Disease: A Review
Mohottige, D., Manley, H. J., & Hall, R. K. (2021) · Kidney360 · doi:10.34067/kid.0001942021 · Cited by 48 · see citing works
Careful use to minimize adverse events of oral antidiabetic medications in the elderly
Scheen, A. J. (2021) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2021.1912735 · Cited by 34 · see citing works
Abdel-Qadir, H. M., Gunn, M., Lega, I. C., Pang, A., Austin, P. C., Singh, S. M., Jackevicius, C. A., Tu, K., Dorian, P., Lee, D. S., et al. (2022) · Journal of the American Heart Association · doi:10.1161/jaha.121.023643 · Cited by 21 · see citing works
Self-citationSimplification of complex insulin therapy: a story of dogma and therapeutic resignation
Giugliano, D., Scappaticcio, L., Longo, M., Caruso, P., Maiorino, M. I., Bellastella, G., & Esposito, K. (2021) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2021.108958 · Cited by 18 · see citing works
Christiaens, A., Henrard, S., Boland, B. B., & Sinclair, A. J. (2022) · Diabetic Medicine · doi:10.1111/dme.14994 · Cited by 17 · see citing works
Mellot, M., Jawal, L., Morel, T., Fournier, J., Tubach, F., Cadwallader, J., Christiaens, A., & Zerah, L. (2024) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2023.11.025 · Cited by 15 · see citing works
Lega, I. C., Yale, J.-F., Chadha, A., Paty, B., Roscoe, R., Snider, M., Steier, J., Bajaj, H. S., Barnes, T., Gilbert, J., et al. (2023) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2023.08.003 · Cited by 12 · see citing works
Self-citationWhen and how to deintensify type 2 diabetes care
Aubert, C. E., Lega, I. C., Bourron, O., Train, A. J., & Kullgren, J. T. (2021) · BMJ · doi:10.1136/bmj-2021-066061 · Cited by 12 · see citing works
Self-citationChristiaens, A., Boureau, A., Guyomarch, B., de Decker, L., Boland, B. B., Hadjadj, S., Cariou, B., HYPOAGE Study Group, Cariou, B., Hadjadj, S., et al. (2024) · Diabetes Care · doi:10.2337/dc24-1058 · Cited by 11 · see citing works
Murea, M., Deira, J., Kalantar‐Zadeh, K., Casino, F. G., & Basile, C. (2021) · Seminars in Dialysis · doi:10.1111/sdi.13027 · Cited by 11 · see citing works
Reducing Care Overuse in Older Patients Using Professional Norms and Accountability
Persell, S. D., Petito, L. C., Lee, J. Y., Meeker, D., Doctor, J. N., Goldstein, N. J., Fox, C. R., Rowe, T. A., Linder, J. A., Chmiel, R., et al. (2024) · Annals of Internal Medicine · doi:10.7326/m23-2183 · Cited by 10 · see citing works
Sugimoto, T., Sakurai, T., Uchida, K., Kuroda, Y., Tokuda, H., Omura, T., Noguchi, T., Komatsu, A., Nakagawa, T., Fujita, K., et al. (2024) · Diabetes Care · doi:10.2337/dc23-2324 · Cited by 10 · see citing works
Pilla, S. J., Jalalzai, R., Tang, O., Schoenborn, N. L., Boyd, C. M., Bancks, M. P., Mathioudakis, N. N., & Maruthur, N. M. (2023) · Journal of General Internal Medicine · doi:10.1007/s11606-023-08506-8 · Cited by 10 · see citing works
Overtreatment and associated risk factors among multimorbid older patients with diabetes
Baretella, O., Alwan, H., Feller, M., Aubert, C. E., Giovane, C. D., Papazoglou, D. D., Christiaens, A., Meinders, A., Byrne, S., Kearney, P. M., et al. (2023) · Journal of the American Geriatrics Society · doi:10.1111/jgs.18465 · Cited by 9 · see citing works
Builes-Montaño, C. E., Wandurraga-Sánchez, E. A., Ramírez, Á., & Ordóñez, J. E. (2023) · Diabetes Therapy · doi:10.1007/s13300-023-01471-9 · Cited by 5 · see citing works
Meier, N., Laager, R., Gregoriano, C., Schütz, P., Müeller, B., Struja, T., & Kutz, A. (2024) · BMJ Open · doi:10.1136/bmjopen-2024-084526 · Cited by 4 · see citing works
Diabetes treatment deintensification in nursing homes: When less is more
Lega, I. C., & Rochon, P. A. (2022) · Journal of the American Geriatrics Society · doi:10.1111/jgs.17832 · Cited by 5 · see citing works
Self-citationManagement of Type 2 Diabetes Mellitus in the Very Elderly: One Practice’s Experience
Grajower, M. M., & LeRoith, D. (2023) · Endocrine Practice · doi:10.1016/j.eprac.2023.03.271 · Cited by 3 · see citing works
Ribero, V. A., Alwan, H., Efthimiou, O., Abolhassani, N., Bauer, D. C., Henrard, S., Christiaens, A., Waeber, G., Rodondi, N., Gencer, B., et al. (2023) · medRxiv · doi:10.1101/2023.03.13.23287105 · Cited by 3 · see citing works
Putallaz, P., Seematter‐Bagnoud, L., Draganski, B., Rouaud, O., Krief, H., & Büla, C. (2024) · BMC Geriatrics · doi:10.1186/s12877-024-05025-x · Cited by 2 · see citing works
Minimising harms of tight glycaemic control in older patients with type 2 diabetes
Thompson, W. (2024) · African Journal of Primary Health Care & Family Medicine · doi:10.4102/phcfm.v16i1.4857 · Cited by 1 · see citing works
Alul- és túlkezelés az idős cukorbeteg gondozása során
Domboróczki, Z., & Molnár, G. A. (2022) · Diabetologia Hungarica · doi:10.24121/dh.2022.27 · Cited by 1 · see citing works
Doucet, J., Guérin, O., Hilbert, C., Bordier, L., Wils, J., Bénichou, J., & Bauduceau, B. (2023) · Drugs & Aging · doi:10.1007/s40266-023-01067-9 · Cited by 1 · see citing works
From burden to benefits: new promises of glucose-lowering treatments in older adults
Christiaens, A. (2024) · Age and Ageing · doi:10.1093/ageing/afae265 · Cited by 1 · see citing works
Adverse events with overtreatment in older adults with diabetes
(2021) · Reactions Weekly · doi:10.1007/s40278-021-90508-2
Hamann, A. (2022) · Die Diabetologie · doi:10.1007/s11428-022-00929-x
Therapeutic choices in elderly diabetic patients
Bordier, L., Doucet, J., & Bauduceau, B. (2023) · Annales d Endocrinologie · doi:10.1016/j.ando.2023.04.003
Biomathematical Analysis on Impedance Measurement During COVID-19 Pandemic
Zhao, B. (2022) · American Journal of Biomedical Science & Research · doi:10.34297/ajbsr.2022.17.002360
Fréquence, causes et conséquences des hypoglycémies chez les personnes âgées diabétiques
Bordier, L., Buysschaert, M., & Bouillet, B. (2023) · Médecine des Maladies Métaboliques · doi:10.1016/s1957-2557(23)00296-1
Particularités d’utilisation des traitements antihyperglycémiants chez les patients âgés
Christiaens, A., Bordier, L., Doucet, J., & Bauduceau, B. (2023) · Médecine des Maladies Métaboliques · doi:10.1016/s1957-2557(23)00304-8
Les objectifs glycémiques chez les sujets âgés
Bordier, L., Darmon, P., & Bauduceau, B. (2023) · Médecine des Maladies Métaboliques · doi:10.1016/s1957-2557(23)00301-2
Az idős cukorbeteg kezelésének speciális szempontjai
Domboróczki, Z. (2023) · Diabetologia Hungarica · doi:10.24121/dh.2023.8
Tan, L. F., & Merchant, R. A. (2024) · Postgraduate Medical Journal · doi:10.1093/postmj/qgae077
Aging In The Face of Diabetes: Severe Hypoglycemia in Older Adults
Ratzki‐Leewing, A. A. (2024) · Canadian Diabetes & Endocrinology Today · doi:10.58931/cdet.2024.2226
Guerra, C., Corréard, F., Montégut, C., Nakache, J., Mascio, T. D., Villani, P., Honoré, S., Daumas, A., Couderc, A., & Bérard, C. (2024) · Research Square · doi:10.21203/rs.3.rs-5349587/v1
Christiaens, A. (2025) · doi:10.1002/9781394205066.ch17
Organ-protective antidiabetic prescriptions in type 2 diabetes – a single institution experience
Siderova, M. V., Shopov, G., Kehayova, G. K., & Dragomanova, S. (2025) · Pharmacia · doi:10.3897/pharmacia.72.e163319
Risks of Tight Glucose Control in Older Adults: Time to Focus Beyond Mortality
Christiaens, A., & Sheppard, J. P. (2025) · Diabetes Care · doi:10.2337/dci25-0068
Kouki, E., Salmela, B., Aro, A. L., Halminen, O., Teppo, K., NISKANEN, L. K., Haukka, J. K., Jukka Putaala, A., Linna, M., Mustonen, P. E., et al. (2026) · Acta Diabetologica · doi:10.1007/s00592-026-02725-1
- Authors
- Lega, I. C., Campitelli, M. A., Austin, P. C., Na, Y., Zahedi, A., Leung, F., Yu, C., Bronskill, S. E., Rochon, P. A., & Lipscombe, L. L.
- Affiliations
- University of Toronto (CA)
- Women's College Hospital (CA)
- Scarborough Health Network (CA)
- St. Michael's Hospital (CA)
- Corresponding author
- Lega, Iliana C.
- ORCID
- Venue
- Diabetologia
- Published
- 2021-01-25
- Volume
- 64
- Issue
- 5
- Pages
- 1093-1102
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W3123510151
- Cited by
- 40
- References
- 49
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 11 · 2023: 12 · 2022: 7 · 2021: 6
- FWCI
- 6.74
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Heart and Stroke Foundation of Canada
- Diabetes Canada
- Ontario Ministry of Health and Long-Term Care
- University of Toronto
- Canadian Institutes of Health Research (1018890)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- older adults, tight glycemic control, glycemic targets, hypoglycemia, insulin, sulfonylureas, adverse events, emergency department visits, hospitalization, mortality
- MeSH terms
- Glycemic Control, Overtreatment, Age Factors, Aged, Aged, 80 and over, Aging, Diabetes Mellitus, Type 2, Female, Humans, Hypoglycemia, Hypoglycemic Agents, Male, Ontario, Retrospective Studies, Risk Factors, Cohort Studies, Prevalence, History, 21st Century, Drug-Related Side Effects and Adverse Reactions
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
