title: Polypharmacy in elderly patients with type 2 diabetes receiving oral antidiabetic treatment.
abstract: OBJECTIVE
  Polypharmacy in older diabetics can have detrimental effects linked to poor adherence and the risk of drug interaction or more serious/frequent side effects. The aim of this study was to identify the characteristics associated with polypharmacy in a cohort of elderly diabetic patients being treated with oral hypoglycemic agents.
  
  
  METHODS
  The study population consisted of 1342 diabetic patients consecutively enrolled in 57 diabetes centers in Italy participating in the METABOLIC Study. Patients meeting the following inclusion criteria were enrolled: diagnosis of type 2 diabetes mellitus, age ≥65 years, and receiving oral antidiabetic treatment. Data concerning diabetes duration and complications, the medications the patients were taking, and the number of hypoglycemic events were registered. Multidimensional impairment was assessed using the Multidimensional Prognostic Index.
  
  
  RESULTS
  The mean age of the participants was 73.3 ± 5.5 years. Polypharmacy, defined as being prescribed contemporaneously at least five drugs, was found in 57.1 % of the study population. According to a multivariable logistic model, the female gender was significantly associated with polypharmacy, as were living in Northern Italian regions, diabetes duration longer than 4 years, and having a body mass index ≥30 kg/m(2). Comorbidities, diabetes complications, a better cognitive performance on the Short Portable Mental Status Questionnaire, and being malnourished/at risk of malnourishment according to the mini nutritional assessment were associated with polypharmacy.
  
  
  CONCLUSIONS
  Polypharmacy, a condition that may lead to many potential detrimental outcomes in older diabetic subjects, was significantly associated with some risk factors that may be useful to identify subjects at risk.
authors.affiliation: CNR - Institute of Neuroscience, Aging Branch, Via Giustiniani 2, 35128, Padua, Italy. marianna.noale@in.cnr.it.
authors.forename: Marianna
authors.initials: M
authors.lastname: Noale
authors.affiliation: Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Veronese
authors.affiliation: Diabetology Unit, University of Turin, Turin, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cavallo Perin
authors.affiliation: Geriatrics Unit, Azienda ULSS, 16, S. Antonio Hospital, Padua, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Pilotto
authors.affiliation: Department of Medicine, University of Padua, Padua, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tiengo
authors.affiliation: CNR - Institute of Neuroscience, Aging Branch, Via Giustiniani 2, 35128, Padua, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Crepaldi
authors.affiliation: CNR - Institute of Neuroscience, Aging Branch, Via Giustiniani 2, 35128, Padua, Italy.
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007558:Italy / Q000453:epidemiology; D008297:Male; D019338:Polypharmacy; D011379:Prognosis; D012737:Sex Factors; D011795:Surveys and Questionnaires
chemical_list: D007004:Hypoglycemic Agents
keywords: METABOLIC Study; Older patients; Polypharmacy; Type 2 diabetes mellitus