title: Can diabetes medication be reduced in elderly patients? An observational study of diabetes drug withdrawal in nursing home patients with tight glycaemic control.
abstract: OBJECTIVE
  To explore the feasibility of withdrawal of diabetes medication in elderly patients with HbA1c<or=6.0%.
  
  
  METHODS
  HbA1c was measured in 98 patients with known diabetes in 17 nursing homes in Sweden. Thirty-two subjects with HbA1c <or=6.0% participated in the drug withdrawal study. After measuring plasma glucose on 3 consecutive days, diabetes drugs were reduced, i.e. complete withdrawal of oral anti-diabetic drugs (OADs), complete insulin withdrawal when doses were <or=20units/day and reduced by half in patients on more than 20units/day.
  
  
  RESULTS
  We identified 31 episodes of plasma glucose <or=4.4mmol/l, most of them nocturnal (n=17). 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%. Six months after baseline investigation mean HbA1c in the intervention group was 5.8+/-1.1% compared with 6.6+/-1.4% in the non-intervention group.
  
  
  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.
authors.affiliation: Söderköping Primary Health Care Centre, Ostra Rydsvägen, S-614 82 Söderköping, Sweden. Peter.Sjoblom@lio.se
authors.forename: Peter
authors.initials: P
authors.lastname: Sjöblom
authors.lastname: AndersTengblad
authors.forename: Ulla-Britt
authors.initials: UB
authors.lastname: Löfgren
authors.forename: Christina
authors.initials: C
authors.lastname: Lannering
authors.forename: Niklas
authors.initials: N
authors.lastname: Anderberg
authors.forename: Ulf
authors.initials: U
authors.lastname: Rosenqvist
authors.forename: Sigvard
authors.initials: S
authors.lastname: Mölstad
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Ostgren
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood* / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents