Report highlights concern that too much medication is being prescribed to older people with type 2 diabetes. 

A recently published report has found that older people with type 2 diabetes could be over treated with certain drugs. 

The findings of the Leicester Diabetes Centre followed a recent NHS Digital report that showed 52 million diabetes prescriptions were issued last year - an increase of 81% over the last 10 years. 

Many newly diagnosed people are older people, reflecting the increase in new cases of type 2 diabetes linked to lifestyle and obesity, with elderly people especially vulnerable to the condition.

The research team from Leicester Diabetes Centre, based at the University of Leicester discovered that potential over-treatment with sulfonylurea and insulin therapies was “common” in people aged 70 or over. 

Prescription pills in wrapper.

Dr Claire Hambling

Dr Clare Hambling, a GP with an interest in diabetes who is based in West Norfolk who led the study, said: “Sulfonylureas are a group of medications commonly used to help people control their type 2 diabetes as they help the pancreas produce more insulin and keep blood sugar levels low.

“However, these treatments have also been linked to a condition called hypoglycemia, which occurs when blood sugar levels drop dangerously low. As people get older the complications of hypoglycemia can be severe, with the risk of injury and poor health outcomes rising significantly. 

“Despite this, evidence suggests many older people with diabetes and other serious health conditions are being over-treated on therapies associated with low blood sugar, which could have serious implications to their health.”

Researchers found older people with type 2 diabetes who were being prescribed sulfonylurea or insulin therapies by using a software tool called Education and Cost-analysis Leading to Improved Prescribing Safety and Efficiency (ECLIPSE Live) - developed to help GPs improve safety in prescribing. The anonymous information they collected also included other health issues the people in the study had, as well as their blood sugar level results across the last few months.

Professor Kamlesh Khunti

Professor Kamlesh Khunti, Professor of Primary Care Diabetes and Vascular Medicine at the University of Leicester, said: “We know from ambulance call-out data that older people are particularly vulnerable to severe hypoglycaemia and they sometimes suffer harm as a consequence, including fractures, head injuries or cardiac events. 

“We are uncertain as to the benefits older people gain from intensive blood glucose management, as well as being concerned that too intensive treatment may inadvertently increase mortality.”

Dr Hambling added: “We believe rolling out nationally the process we used to find older people who are being over treated, we can adapt their medication which could help alleviate hypoglycaemia and associated complications, which will improve people’s health and save NHS resources.” 

Following the publication of the report education and guidelines have been created to help clinicians manage older people with diabetes and other co-existing complex healthcare needs.

Read the report in Diabetic Medicine 
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