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4CPS-121 Optimising antidiabetic treatment for elderly patients according to their functional status
  1. L Rubio-Ruiz1,
  2. N Fernández-Fernández2,
  3. M Castro-Rodríguez2,
  4. M Hijazi-Vega1,
  5. M Gómez-Bermejo1,
  6. T Molina-García1
  1. 1Hospital Universitario De Getafe, Pharmacy, Getafe, Spain
  2. 2Hospital Universitario De Getafe, Geriatric, Getafe, Spain


Background and Importance Treatments for elderly patients with diabetes mellitus (DM) prioritise improving the quality of life, preserving their functional status, and avoiding hypoglycemia, which is associated with an increased risk of falling, morbidity and mortality.

Aim and Objectives The aim of this work is to determine the DM prevalence in hospitalised patients at the Acute Geriatric Unit (AGU) and to assess the adherence to the recommendations stablished by the American Diabetes Association (ADA). These recommendations include having an adequate antidiabetic treatment based on patients’ functional status and an updated glycated haemoglobin (HbA1c) value.

Material and Methods This observational, retrospective study includes hospitalised patients admitted to the AGU and discharged between January and February 2023.

We collected HbA1c values and functional status (Barthel Index) of AGU DM patients. The HbA1c was consider as updated if the measure was done during the hospitalisation or the last three months.

The antidiabetic treatment adequation was evaluated based on HbA1c and patient functionality. The HbA1c ADA recommendations are 7–7.5%(functionally independent patients), 7.5–8%(functionally dependent patients), and prevent symptomatic hyperglycemia (end-of-life). The patients were categorised as controlled (complies with ADA´s recommendations), over-controlled (lower HbA1c levels) and inadequately controlled (higher HbA1c levels).

Modifications to antidiabetic treatment at discharge were documented including the drugs involved and the type of modification applied (treatment or dose initiation/increase, discontinuation/reduction).

Results This study includes 300 patients with a 33%prevalence of DM at the AGU (107 patients). From the diabetic patients, 90%(n=96) had an updated mean value of HbA1c of 7.4±1.5%. Among these 96 patients, 46%achieved appropriate control, 41%were over-controlled and 13%were inadequately controlled. Thus, 52 patients(54%) had an inadequate disease control either excessive or insufficient.

From these 52 patients with inadequate control, 75%had guideline-based antidiabetic treatment modifications. The main drug groups involved were insulins(46%), biguanides(27%), and DPP-4 inhibitors(13%). The treatment modifications applied were 75%discontinuation/reduction and 25%initiation/increase.

Conclusion and Relevance Approximately one-third of AGU patients have diabetes and, in most the cases, an updated HbA1c values were available.

On hospital admission, over half of the patients did not follow ADA recommendations for metabolic control, leading to over-control. Most patients with inadequate control had discharge changes ADA recommendations based. Main modification were discontinuation or dose reduction in antidiabetic treatment.

Conflict of Interest No conflict of interest.

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