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

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.