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GPs worried about effect of therapy in older diabetes patients

By Lilian Anekwe

GPs are less likely to treat older patients with type 2 diabetes than their younger counterparts, a survey by UK researchers reveals.

The survey was conducted between November and December 2009 among 300 UK GPs with patients aged 18 and over who were untreated with anti-hyperglycaemia drugs for more than six months after their diagnosis.

GPs were asked the reasons, according to a 36-point questionnaire, why they had not initiated therapy in these patients. The responses were grouped into four categories: mild hyperglycaemia, concerns related to antihyperglycaemia therapy, issues with comorbidities and/or polypharmacy and the patient's own concerns.

Some 792 patients under 65 and 780 patients over 65 were identified. There was no difference in the proportion of patients in the older and younger age groups who had an HbA1c level of 7% or higher.

GPs were more likely with older than younger patients not to initiate therapy because of concerns related to therapy, (49% versus 40%) and issues with comorbidity or polypharmacy (35% versus 20%).

Study leader Professor Alan Sinclair, professor of medicine at the University of Bedfordshire, said: ‘Nearly one third of patients who were not treated with antihyperglycaemics had an HbA1c of more than 7%, with many older patients having evidence of vascular complications.

‘Despite mild hyperglycaemia being a main reason for non-treatment, our findings suggest that other concerns, such as hypoglycaemia, operate in the non-treatment of type 2 diabetes among older patients.'

American Diabetes Association scientific sessions abstract 1093-P.

GPs worried about effect of therapies, such as insulin, in older diabetes patients