• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Chronic Disease

Insulin discontinuation among patients over 75 more common in healthier patients

byJalal EbrahimandAnees Daud
September 27, 2019
in Chronic Disease, Endocrinology, Public Health
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. In this large, longitudinal cohort study from the United States, patients with poor health status were more likely to continue insulin use compared with healthier patients.

Evidence Rating Level: 2 (Good)

Study Rundown: Type 2 Diabetes Mellitus (DM2) is one of the most common chronic illnesses in the world. Glycemic control has been shown to improve micro and macrovascular outcomes, however results take time. Optimal adjustment of management in those 75 or older, especially with multiple comorbidities, is unclear as they are often excluded from clinical trials. Recommendations are to have looser glycemic control with older age and more comorbidities because of consequences of hypoglycemia.  This longitudinal study found that insulin continuation in those 75 or older was linked with poorer health status, wherein those with more comorbidities were more likely to continue insulin use.

Limitations of this study included an oversimplified stratification of health status, inability to capture differences in insulin dosing (which means only total cessation was captured, rather than potential dose reductions), as well as inability to confirm if the cessation was driven by clinician recommendation or patient choice. Overall, further study is warranted to evaluate if older, more frail patients who are more susceptible to hypoglycemia are having insulin dosing appropriately lowered or stopped.

Click to read the study in JAMA Internal Medicine

Relevant Reading: Intensive Blood Glucose Control and Vascular Outcomes in Patients with Type 2 Diabetes

In-Depth [prospective cohort]: This was a longitudinal cohort study of patients 75 and older with type 2 diabetes mellitus (DM2). The baseline cohort included those who used insulin at enrollment (n=21 531, baseline cohort of 4076). The primary outcome was insulin discontinuation in the next 4 years. Data was collected from 2009 to 2017. Patients were stratified into poor (any indicator of end stage disease including home oxygen use, metastatic cancer, Stage V CKD, dialysis, or dementia), intermediate (2 comorbidities and no weekly exercise, >2 comorbidities, or use of a walker), and good health (<2 comorbidities or 2 comorbidities with any weekly exercise).

RELATED REPORTS

The Scan by 2 Minute Medicine®: Endometriosis Awareness Month, OnlineMedEd Charges, Canadian Grocery Store Controversy, BetterHelp’s Privacy Concerns

The Scan by 2 Minute Medicine®: Erythritol and Heart Problems, Maternal Health Trends, the Next Big Thing in Diabetes, and Declining Levels of Sea Ice

The Scan by 2 Minute Medicine®: Black History Month, Mr.Beast, Damar Hamlin and on-field CPR, Ozempic Shortage

There were 1,335 patients (32.7% of baseline cohort) who discontinued insulin within 4 years. Insulin discontinuation was highest in the cohort with good health (38.9% vs 32.7% intermediate health vs 27.6% poor health). Adjusted risk ratio for insulin continuation for those with poor health was 1.47, 95% CI 1.27-1.67, p<0.01) compared to those with good health.

Image: PD

©2019 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: diabetesgeriatric medicinehypoglycemiainsulinType 2 Diabetes Mellitus
Previous Post

Early revascularization improves survival in patients with ischemia demonstrated on positron emission tomography perfusion imaging

Next Post

Quick Take: Risk of rhabdomyolysis with donepezil compared with rivastigmine or galantamine

RelatedReports

The Scan by 2 Minute Medicine®:  Ultra-Trail du Mont-Blanc, Taylor Swift, NBA rookie Chet Holmgren and Magic Mushrooms!
The Scan by 2 Minute Medicine®

The Scan by 2 Minute Medicine®: Endometriosis Awareness Month, OnlineMedEd Charges, Canadian Grocery Store Controversy, BetterHelp’s Privacy Concerns

March 21, 2023
The Scan by 2 Minute Medicine®:  Ultra-Trail du Mont-Blanc, Taylor Swift, NBA rookie Chet Holmgren and Magic Mushrooms!
The Scan by 2 Minute Medicine®

The Scan by 2 Minute Medicine®: Erythritol and Heart Problems, Maternal Health Trends, the Next Big Thing in Diabetes, and Declining Levels of Sea Ice

March 7, 2023
The Scan by 2 Minute Medicine®:  Ultra-Trail du Mont-Blanc, Taylor Swift, NBA rookie Chet Holmgren and Magic Mushrooms!
The Scan by 2 Minute Medicine®

The Scan by 2 Minute Medicine®: Black History Month, Mr.Beast, Damar Hamlin and on-field CPR, Ozempic Shortage

March 14, 2023
Prescription of antibiotics for acute respiratory infections increasing
Endocrinology

Sodium-glucose cotransporter 2 inhibitors may reduce incidence of respiratory events in Type 2 diabetics

February 16, 2023
Next Post
Quick Take: Risk of rhabdomyolysis with donepezil compared with rivastigmine or galantamine

Quick Take: Risk of rhabdomyolysis with donepezil compared with rivastigmine or galantamine

Pediatric DKA associated with recent acute care visits

Quick Take: Glycemic durability of an early combination therapy with vildagliptin and metformin versus sequential metformin monotherapy in newly diagnosed type 2 diabetes (VERIFY)

Blood pressure variability associated with cardiovascular disease and mortality

Quick Take: Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER)

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Synergistic interaction between risk burden and genetics for atrial fibrillation development
  • Nivolumab plus ipilimumab does not improve survival in post-nephrectomy patients with renal cell carcinoma
  • Specific histopathologic renal lesions may be associated with increased risk of cardiovascular disease
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options