title: Do age and comorbidity affect intensity of pharmacological therapy for poorly controlled diabetes mellitus?
abstract: OBJECTIVE
  To examine the influence of age and comorbidity on intensification of medical therapy for patients with poorly controlled diabetes mellitus (DM).
  
  
  METHODS
  Observational cohort study using data from Department of Veterans Affairs (VA) national databases.
  
  
  METHODS
  Thirteen VA medical centers in New England, Florida, and Puerto Rico.
  
  
  METHODS
  Veterans (N=5,317) with poorly controlled DM receiving regular medical care
  
  
  METHODS
  An increase in hypoglycemic medications, or intensification of therapy, was considered present at the visit if a new hypoglycemic medication was started or the dosage of an existing medication was increased.
  
  
  RESULTS
  The overall rate of intensification of therapy was 20.8% (1,106/5,317). The rate of intensification was highest in the youngest patients without comorbidity (24.5%) and lowest in the oldest patients with comorbidity (15.7%) (P<.001).
  
  
  CONCLUSIONS
  Rates of intensification at a single clinic visit were quite low in all groups and were lowest in older patients with comorbidity.
authors.affiliation: Clinical Epidemiology Research Center, Department of Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06520, USA. sarwat.chaudhry@yale.edu
authors.forename: Sarwat I
authors.initials: SI
authors.lastname: Chaudhry
authors.forename: Dan R
authors.initials: DR
authors.lastname: Berlowitz
authors.forename: John
authors.initials: J
authors.lastname: Concato
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged
chemical_list: D007004:Hypoglycemic Agents