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Do age and comorbidity affect intensity of pharmacological therapy for poorly controlled diabetes mellitus?
Sarwat I Chaudhry1, Dan R Berlowitz, John Concato
1Clinical Epidemiology Research Center, Department of Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut 06520, USA. sarwat.chaudhry@yale.edu
Objectives:
To examine the influence of age and comorbidity on intensification of medical therapy for patients with poorly controlled diabetes mellitus (DM).
Design:
Observational cohort study using data from Department of Veterans Affairs (VA) national databases.
Setting:
Thirteen VA medical centers in New England, Florida, and Puerto Rico.
Participants:
Veterans (N=5,317) with poorly controlled DM receiving regular medical care
Measurements:
An increase in hypoglycemic medications, or intensification of therapy, was considered present at the visit if a new hypoglycemic medication was started or the dosage of an existing medication was increased.
Results:
The overall rate of intensification of therapy was 20.8% (1,106/5,317). The rate of intensification was highest in the youngest patients without comorbidity (24.5%) and lowest in the oldest patients with comorbidity (15.7%) (P<.001).
Conclusion:
Rates of intensification at a single clinic visit were quite low in all groups and were lowest in older patients with comorbidity.
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