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Deprescribing Glucose-Lowering Therapy in Older Adults with Diabetes: A Systematic Review of Recommendations

  • Antoine Christiaens
    Affiliations
    Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Paris, France
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  • Séverine Henrard
    Affiliations
    Université catholique de Louvain (UCLouvain), Louvain Drug Research Institute (LDRI), Clinical Pharmacy Research Group, Brussels, Belgium
    Université catholique de Louvain (UCLouvain), Institute of Health and Society (IRSS), Brussels, Belgium
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  • Alan J. Sinclair
    Affiliations
    King’s College London, London, United Kingdom
    Foundation for Diabetes Research in Older People, Taplow, Buckinghamshire, United Kingdom
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  • Florence Tubach
    Affiliations
    Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Paris, France
    Unité de Recherche Clinique PSL-CFX, Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Pitié Salpêtrière, Paris, France
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  • Dominique Bonnet-Zamponi
    Affiliations
    Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Paris, France
    Observatoire des médicaments, dispositifs médicaux, Innovations thérapeutiques d’Île-de-France (OMéDIT IDF), Paris, France
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  • Lorène Zerah
    Affiliations
    Sorbonne Université, INSERM, Institut Pierre Louis d’Epidémiologie et de Santé Publique (IPLESP), Paris, France
    Département de gériatrie, Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Pitié Salpêtrière, Paris, France
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Published:January 23, 2023DOI:https://doi.org/10.1016/j.jamda.2022.12.018
      Overtreatment by glucose-lowering treatment (GLT) is frequent, and may induce harmful hypoglycemic events in older people with type 2 diabetes (T2D), significantly increasing morbidity and mortality.
      • Deng Z.
      • Thompson W.
      • Korenvain C.
      • et al.
      Benefits and harms of deprescribing antihyperglycemics for adults with type 2 diabetes: A systematic review.
      Avoiding overtreatment by GLT, either by prescribing appropriate GLT according to their individual risks-benefits balance or by deprescribing GLT, is therefore a key issue in the management of older patients, as recommended by various scientific societies these last years.
      • Christiaens A.
      • Henrard S.
      • Zerah L.
      • et al.
      Individualisation of glycaemic management in older people with type 2 diabetes: A systematic review of clinical practice guidelines recommendations.
      Nevertheless, there is currently no consensus on the definition of GLT overtreatment in older people,
      • Christiaens A.
      • Henrard S.
      • Boland B.
      • et al.
      Overtreatment of older people with type 2 diabetes-a high impact frequent occurrence in need of a new definition.
      which prevents a clear statement on which patients should undergo deprescribing of GLT. It is therefore worthwhile to define the profiles of patients for whom GLT should be deprescribed. This systematic review of clinical practice guidelines (CPGs) aimed to compare the recommendations defining profiles of older patients in whom deprescribing GLT is recommended.
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