American Diabetes Association
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A National Physician Survey of Deintensifying Diabetes Medications for Older Adults with Type 2 Diabetes

posted on 2023-02-17, 20:54 authored by Scott J. Pilla, Rabia Jalalzai, Olive Tang, Nancy L. Schoenborn, Cynthia M. Boyd, Sherita H. Golden, Nestoras N Mathioudakis, Nisa M. Maruthur


Objective: Determine physicians’ approach to deintensifying (reducing/stopping), or switching hypoglycemia-causing medications for older adults with type 2 diabetes.

Research Design and Methods: In this national survey, U.S. physicians in general medicine, geriatrics, or endocrinology reported changes they would make to hypoglycemia-causing medications for older adults in three scenarios: good health, HbA1c 6.3%; complex health, HbA1c 7.3%; poor health, HbA1c of 7.7%.

Results: There were 445 eligible respondents (response rate 37.5%). In patient scenarios, 48%, 4%, and 20% of physicians deintensified hypoglycemia-causing medications for patients with good, complex, and poor health, respectively. Overall, 17% of physicians switched medications without significant differences by patient health. Half of physicians selected HbA1c targets below guidelines for older adults with complex or poor health.

Conclusion: Most U.S. physicians would not deintensify or switch hypoglycemia-causing medications within guideline-recommended HbA1c targets. Physicians’ preference for lower HbA1c targets than guidelines needs to be addressed to optimize deintensification decisions.


Johns Hopkins KL2 Clinical Research Scholars Program x KL2TR003099

U.S. Department of Health and Human Services > National Institutes of Health > National Institute of Diabetes and Digestive and Kidney Diseases K23DK128572 R01DK125780

U.S. Department of Health and Human Services > National Institutes of Health > National Institute on Aging 1R24AG064025 K24AG056578 K76AG059984

U.S. Deprescribing Research Network x 1R24AG064025


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