title: Comparison of physician practice patterns for older adults compared to NHANES diabetes cohort on oral/other therapy.
abstract: The American Diabetes Association and European Association for the Study of Diabetes issued a new patient-centered approach for the management of hyperglycemia in patients with Type 2 diabetes. With a focus on older adults and the elderly, the authors explored the alignment of elements of the suggested framework with patients' reports of receiving combination or monotherapy using US national survey data (National Health and Nutrition Examination Survey 2001-2010) and a physician survey. Combination therapy was positively associated with age (range: 1.56-1.63; p = 0.04-0.07), obesity (odds ratio [OR]: 1.40; p = 0.01), HbA(1c) ≥7.0 (OR: 2.00; p < 0.01), number of years of living with diabetes (OR: 1.02 per year; p = 0.01) and hyperlipidemia (OR: 1.36; p = 0.02). An interaction term between years of living with diabetes and comorbidities >1 pointed to a trend of those with comorbidities >1 to be less probable to report combination therapy (OR: 0.98; p = 0.07) per additional year of diabetes history. Results suggest that sicker, older patients might benefit from more aggressive therapy, in the context of diabetes prevalence, this is expected to continue rising in that population.
authors: University of Maryland School of Pharmacy, Baltimore, MD, USA. fshaya@rx.umaryland.edu
authors: Fadia T
authors: FT
authors: Shaya
authors: Viktor V
authors: VV
authors: Chirikov
authors: Morgan
authors: M
authors: Bron
authors: DeLeonardo
authors: D
authors: Howard
authors: Clyde
authors: C
authors: Foster
authors: Xia
authors: X
authors: Yan
authors: Niharika
authors: N
authors: Khanna
authors: Verlyn O
authors: VO
authors: Warrington
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D004359:Drug Therapy, Combination; D004363:Drug Utilization; D017723:Drug Utilization Review; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D019983:Guideline Adherence; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D016017:Odds Ratio; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; C517652:hemoglobin A1c protein, human