Large discrepancy in glycaemic control appropriateness in geriatric patients with type 2 diabetes according to major clinical practice guidelines

2021 ◽  
Author(s):  
Antoine Christiaens ◽  
Séverine Henrard ◽  
Benoit Boland
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Practice ◽  
Glycaemic Control ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Geriatric Patients

530 INTERPRETATION OF HBA1C VALUES IN GERIATRIC PATIENTS WITH TYPE 2 DIABETES: LARGE DIVERGENCE BETWEEN CLINICAL PRACTICE GUIDELINES

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii1-ii4
Author(s):  
A Christiaens ◽  
B Boland ◽  
S Henrard
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Practice ◽  
Health Status ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Geriatric Patients ◽  
High Risk Population ◽  
Endocrine Society ◽  
Hba1c Target

Abstract Introduction An individualised glycated haemoglobin (HbA1c) target according to the patients’ health status is central in the glycaemic management of geriatric people with type 2 diabetes (T2D) in order to avoid hypoglycaemic events through an appropriate management of the glucose-lowering therapy (GLT). Current clinical practice guidelines (CPGs) provide different recommendations for patients’ HbA1c targets. Using real-life data from geriatric patients, this study aimed at assessing the concordance in interpretation of HbA1c values according to three current major CPGs from the Diabetes Canada-2018 (DC18), the Endocrine Society-2019 (ES19) and the American Diabetes Association-2020 (ADA20). Introduction Retrospective study in consecutive older patients (≥75 years) with T2D admitted to a Belgian geriatric ward, with GLT before admission and HbA1c measurement during the hospital stay. Patients were classified into three categories of HbA1c values according to the CPGs recommendations: in-target HbA1c (appropriate-GLT), too-low HbA1c (GLT-overtreatment) and too-high HbA1c (GLT-undertreatment). Concordance of health status classifications and GLT categories between the three CPGs was assessed using Cohen’s and Fleiss’ κ, respectively. Results Of the 318 patients (median age 84 years, 54% women), one-third were in intermediate health and two-thirds in poor health (κ = 0.86; excellent concordance). According to the DC18, ES19 and ADA20 CPGs, HbA1c was in-target for respectively 46%, 25% and 82% of the patients, and too-low HbA1c (GLT-overtreatment) was present in 28%, 57% and 0% (κ = 0.36; low concordance). Results Patients’ HbA1c values are interpreted differently according to these major CPGs, mainly because of differences in their recommendations about HbA1c target individualisation and specifically the definition of a too-low HbA1c value. In clinical practice, these diverging interpretations regarding overtreatment may lead to unsafe GLT prescribing and thereby to hypoglycaemic events in this high-risk population.

Prevention and screening recommendations in type 2 diabetes: Review and critical appraisal of clinical practice guidelines

2019 ◽  
Vol 13 (3) ◽  
pp. 197-203 ◽  
Author(s):  
Mohammad Diab ◽  
Huda A. Barhoosh ◽  
Balqis Daoudi ◽  
Sawsan I. AlMukdad ◽  
Nancy HA. Zaghloul ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Critical Appraisal

scholarly journals 2019 Clinical Practice Guidelines for Type 2 Diabetes Mellitus in Korea

2019 ◽  
Vol 43 (4) ◽  
pp. 398 ◽  
Author(s):  
Mee Kyoung Kim ◽  
Seung-Hyun Ko ◽  
Bo-Yeon Kim ◽  
Eun Seok Kang ◽  
Junghyun Noh ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines

Management of type 2 diabetes using non‐insulin glucose‐lowering therapies: a critical appraisal of clinical practice guidelines with the AGREE II instrument

2020 ◽  
Vol 37 (4) ◽  
pp. 636-647 ◽  
Author(s):  
W. M. J. Lam ◽  
R. Al‐Khalifah ◽  
I. D. Florez ◽  
L. Cruz‐Lopes ◽  
M. F. Sekercioglu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Critical Appraisal ◽  
Agree Ii ◽  
Glucose Lowering ◽  
Agree Ii Instrument

scholarly journals PDB92 - PHYSICIANS’ ADHERENCE TO CLINICAL PRACTICE GUIDELINES IN THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS ELDERLY PATIENTS. THE IMPLICA2 STUDY

2018 ◽  
Vol 21 ◽  
pp. S134
Author(s):  
S. Aceituno ◽  
J. Franch-Nadal ◽  
F. García - Gollarte ◽  
A. Pérez del Molino ◽  
M.L. Orera - Peña ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Practice ◽  
Elderly Patients ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines

scholarly journals Quality of Clinical Practice Guidelines for Glycemic Control in Type 2 Diabetes Mellitus

PLoS ONE ◽  
2013 ◽  
Vol 8 (4) ◽  
pp. e58625 ◽  
Author(s):  
Haley K. Holmer ◽  
Lauren A. Ogden ◽  
Brittany U. Burda ◽  
Susan L. Norris
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Practice ◽  
Glycemic Control ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines

Membership in a diabetes-care network and adherence to clinical practice guidelines for treating type 2 diabetes among general practitioners: A four-year follow-up

2016 ◽  
Vol 10 (5) ◽  
pp. 342-351 ◽  
Author(s):  
Ludovic Casanova ◽  
Aurélie Bocquier ◽  
Sébastien Cortaredona ◽  
Stève Nauleau ◽  
Laurent Sauze ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Practice ◽  
General Practitioners ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Diabetes Care ◽  
Care Network

2011 Clinical Practice Guidelines for Type 2 Diabetes in Korea

2011 ◽  
Vol 12 (4) ◽  
pp. 183 ◽  
Author(s):  
Seung-Hyun Ko ◽  
Dong-Joon Kim ◽  
Seung-Joon Oh ◽  
Hye-Jin Lee ◽  
Kang-Hee Shim ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines
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