Do age and comorbidity affect intensity of pharmacological therapy for poorly controlled diabetes mellitus?
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.
Chaudhry
Sarwat I
SI
Clinical Epidemiology Research Center, Department of Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06520, USA. sarwat.chaudhry@yale.edu
Berlowitz
Dan R
DR
Concato
John
J
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
D007004:Hypoglycemic Agents