Do Age and Comorbidity Affect Intensity of Pharmacological Therapy for Poorly Controlled Diabetes Mellitus?

Abstract

To examine the influence of age and comorbidity on intensification of medical therapy for patients with poorly controlled diabetes mellitus (DM). Observational cohort study using data from Department of Veterans Affairs (VA) national databases. Thirteen VA medical centers in New England, Florida, and Puerto Rico. Veterans (N=5,317) with poorly controlled DM receiving regular medical care 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. 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). Rates of intensification at a single clinic visit were quite low in all groups and were lowest in older patients with comorbidity.