Academic Journal
Frailty and overtreatment in older adults with type 2 diabetes in an Argentine health system.
| Τίτλος: | Frailty and overtreatment in older adults with type 2 diabetes in an Argentine health system. |
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| Συγγραφείς: | Martingano I; Servicio de Clínica Médica, Hospital Italiano, Argentina., Lopez Gutierrez MP; Servicio de Clínica Médica, Hospital Italiano, Argentina., Maccio AM; Servicio de Clínica Médica, Hospital Italiano, Argentina., Burgos MA; Área de Investigación en Medicina Interna, Hospital Italiano, Argentina., Perman G; Servicio de Clínica Médica, Hospital Italiano, Argentina., Russo MP; Servicio de Clínica Médica, Hospital Italiano, Argentina., Grande Ratti MF; Área de Investigación en Medicina Interna, Hospital Italiano, Argentina. Electronic address: maria.grande@hospitalitaliano.org.ar. |
| Πηγή: | Endocrinologia, diabetes y nutricion [Endocrinol Diabetes Nutr (Engl Ed)] 2026 Jun-Jul; Vol. 73 (6), pp. 501745. Date of Electronic Publication: 2026 Mar 31. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Country of Publication: Spain NLM ID: 101717565 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2530-0180 (Electronic) Linking ISSN: 25300180 NLM ISO Abbreviation: Endocrinol Diabetes Nutr (Engl Ed) Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [Barcelona] : [Elsevier España], 2017- |
| Ιατρικοί όροι (MeSH): | Diabetes Mellitus, Type 2*/drug therapy , Diabetes Mellitus, Type 2*/epidemiology , Diabetes Mellitus, Type 2*/complications , Diabetes Mellitus, Type 2*/blood , Frailty*/epidemiology , Overtreatment*/statistics & numerical data , Frail Elderly*/statistics & numerical data, Argentina/epidemiology ; Hypoglycemic Agents/therapeutic use ; Hypoglycemic Agents/adverse effects ; Glycated Hemoglobin/analysis ; Humans ; Aged ; Cross-Sectional Studies ; Female ; Male ; Aged, 80 and over ; Prevalence ; Polypharmacy ; Comorbidity |
| Περίληψη: | Objectives: To describe the clinical and sociodemographic characteristics of people aged 65 years or older with type 2 diabetes mellitus, estimate the prevalence of frailty, and explore its association with metabolic control and pharmacological regimens used. Methods: We conducted a cross-sectional study with consecutive sampling of patients, active members of an integrated health service network in Argentina as of March 1st, 2022. Frailty was assessed using the Electronic Screening Index of Frailty, considering frail those with ≥ 9 coded clinical conditions. Glycemic control was defined according to individualized HbA1c goals (<7% non-frail, <8% frail), and overtreatment as the use of drugs with a high risk of hypoglycemia (insulin, sulfonylureas, and/or glinides) in patients at goal. Results: A total of 5,937 individuals (mean age, 78 years; 20% older than 85 years) were included. Hypertension and dyslipidemia were the most prevalent comorbidities, and 68% had polypharmacy. Frailty was 8.92% (95%CI, 8.21-9.68), doubling in individuals older than 85 years. Frail patients had more chronic complications and achieved glycemic goals more frequently (57% vs 42%), but at the expense of greater use of risky drugs (37% vs 20%) and overtreatment (23.7% vs 5.9%; aOR, 5.00; 95%CI, 3.88-6.45). Conclusions: Frailty was associated with a higher risk of overtreatment. It is essential to implement individualized management strategies, deprescribing, and adjusting goals according to functional status. Based on this real-world evidence, we seek to contribute elements for a critical review of current policies and strategies in Latin America. (Copyright © 2025 SEEN and SED. Published by Elsevier España, S.L.U. All rights reserved.) |
| Contributed Indexing: | Keywords: Anciano frágil; Argentina; Diabetes mellitus; Envejecimiento saludable; Fragilidad; Frail elderly; Frailty; Healthy aging; List of potentially inappropriate drugs; Lista de medicamentos potencialmente inapropiados |
| Substance Nomenclature: | 0 (Hypoglycemic Agents) 0 (Glycated Hemoglobin) |
| Entry Date(s): | Date Created: 20260402 Date Completed: 20260617 Latest Revision: 20260617 |
| Update Code: | 20260618 |
| DOI: | 10.1016/j.endien.2026.501745 |
| PMID: | 41925490 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2530-0180 |
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| DOI: | 10.1016/j.endien.2026.501745 |