CoChat
Sign Up
Cited by 9Diabetes Treatment and ManagementPharmaceutical Practices and Patient OutcomesDiabetes Management and Research

Impact of Age, Frailty, and Dementia on Prescribing for Type 2 Diabetes at Hospital Discharge 2012–2016

Open access
Wood, Stephen J., Bell, J.S., Magliano, D.J., Fanning, L., Cesari, M., Keen, C.S., Ilomäki, J.·2021·The Journal of Frailty & Aging
DOI 10.14283/jfa.2021.6
Open this paper in CoChat — free account

Abstract

BACKGROUND: The risks of intensive blood glucose lowering may outweigh the benefits in vulnerable older people. OBJECTIVES: Our primary aim was to determine whether age, frailty, or dementia predict discharge treatment types for patients with type 2 diabetes (T2D) and related complications. Secondly, we aimed to determine the association between prior hypoglycemia and discharge treatment types. DESIGN, SETTING AND PARTICIPANTS: We conducted a cohort study involving 3,067 patients aged 65-99 years with T2D and related complications, discharged from Melbourne's Eastern Health Hospital Network between 2012 and 2016. MEASUREMENTS: Multinomial logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CI) for the association between age, frailty, dementia and hypoglycemia, and being prescribed insulin-only, non-insulin glucose-lowering drugs (GLDs) or combined insulin and non-insulin GLDs compared to no GLD. International Classification of Diseases-10 codes were used to identify dementia status and prior hypoglycemia; frailty was quantified using the Hospital Frailty Risk Score. RESULTS: Insulin-only, non-insulin GLDs, combined insulin and non-insulin GLDs, and no GLDs were prescribed to 19%, 39%, 20%, and 23% of patients, respectively. Patients >80 years were less likely than patients aged 65-80 to be prescribed any of the GLD therapies, (eg. non-insulin GLDs [OR 0.67; 95%CI 0.55-0.82]), compared to no GLD. Similarly, high vs. low frailty scores were associated with not being prescribed any of the three GLD therapies, (eg. non-insulin GLDs [OR 0.63; 95%CI 0.45-0.87]). However, dementia was not associated with discharge prescribing of GLD therapies. Patients with a hypoglycemia-related admission were more likely than those not hospitalized with hypoglycemia to receive insulin-only (OR 4.28; 95%CI 2.89-6.31). CONCLUSIONS: Clinicians consider age and frailty when tailoring diabetes treatment regimens for patients discharged from hospital with T2D and related complications. There is scope to optimize prescribing for patients with dementia and for those admitted with hypoglycemia.

Integrity signals

Registry

Crossref · 10.14283/jfa.2021.6

Cites

28 of 28 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • HCPs tailored care for patients with MLTCiD by adapting diabetic medications management, based on patients' ability to follow dosage instructions, but this approach was not widespread (CMOC11).

    “In contrast, we found evidence of HCPs tailoring care for patients with MLTCiD by adapting diabetic medications management, based on patients’ ability to follow dosage instructions, but this approach was not widespread (CMOC11) [53, 87].”

    From Do hospital-to-home transitions work for older adults with multiple long-term conditions including dementia? A realist review (2025) · cites this paper as [87]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Wood, S. J., Bell, J. S., Magliano, D. J., Fanning, L., Cesari, M., Keen, C. S., & Ilomäki, J.
Affiliations
  • Monash University (AU)
  • National Health and Medical Research Council (AU)
  • Baker Heart and Diabetes Institute (AU)
  • Eastern Health (AU)
  • University of Milan (IT)
ORCID
Venue
The Journal of Frailty & Aging
Publisher
Elsevier BV
Published
2021-10
Volume
10
Issue
4
Pages
343-349
ISSN
2260-1341 (ISSN-L)
DOI
10.14283/jfa.2021.6
OpenAlex
W3131265298
Cited by
9
References
28
Citations by year
2025: 2 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 3
FWCI
1.30
Type
journal article
Language
en
Open access
Licence
Locations
  • The Journal of Frailty & Aging (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
type 2 diabetes, hospital discharge prescribing, frailty, dementia, age, hypoglycemia, insulin, antidiabetic drugs, older adults, Hospital Frailty Risk Score, diabetes complications, glycemic control, treatment intensification, hospital readmission
MeSH terms
Frailty, Aged, Dementia, Diabetes Mellitus, Type 2, Hospitals, Humans, Patient Discharge, Cohort Studies

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