TY - JOUR
T1 - The effect of frailty on post-discharge management and outcomes of acute glycaemic crises
T2 - Analysis of admissions for hypoglycaemia and hyperglycaemia in Australia
AU - Morton, Jedidiah I.
AU - Ilomäki, Jenni
AU - Wood, Stephen J.
AU - Liau, Shin J.
AU - Steeper, Michelle
AU - Doody, Hannah
AU - Bell, J. Simon
N1 - Funding Information:
JI has received grant or consulting funds from the National Health and Medical Research Council, Medical Research Future Fund, Dementia Australia Research Foundation, Yulgilbar Foundation, National Breast Cancer Foundation, AstraZeneca, and Amgen unrelated to this work. JSB has received grant funding or consulting funds from the National Health and Medical Research Council, Medical Research Future Fund, Victorian Government Department of Health, Dementia Australia Research Foundation, Yulgilbar Foundation, Aged Care Quality and Safety Commission, Dementia Centre for Research Collaboration, Pharmaceutical Society of Australia, GlaxoSmithKline Supported Studies Programme, Amgen, and several aged care provider organisations unrelated to this work; all grants and consulting funds were paid to the employing institution.
Funding Information:
SJL was supported by a postgraduate research scholarship funded by Monash University, and the Australian Government Research Training Program Scholarship. JSB is supported by a National Health and Medical Research Council (NHMRC) Dementia Leadership Fellowship.
Publisher Copyright:
© 2024 The Author(s)
PY - 2024/3
Y1 - 2024/3
N2 - Objective: To describe changes in glucose-lowering drug (GLD) dispensing by frailty status for people with diabetes following admission for hypoglycaemia or hyperglycaemia. Methods: This study included all people with probable type 2 diabetes in the state of Victoria, Australia, admitted to hospital for hypoglycaemia (n = 2,506 admissions) or hyperglycaemia (n = 1,693) between 1 July 2013 and 29 June 2017. Frailty was defined via the Hospital Frailty Risk Score (HFRS). We examined differences in dispensing of GLDs in the year before and after admission using linear regression models adjusted for age, sex, comorbidities, and socioeconomic status. Results: Dispensing of GLDs decreased following hypoglycaemia admission. Decreased dispensing was strongly associated with frailty status, with a change in mean annual GLD dispensing count of −4.11 (−5.05, −3.17) for an HFRS of 15 vs. −0.99 (−1.47, −0.50) for an HFRS of 0. Changes were greatest for metformin and sulfonylureas. Following hyperglycaemia admission, the mean number of annual GLD dispensings increased, with a smaller increase with increasing frailty: 2.44 (1.32, 3.56) for an HFRS of 0 vs. 1.16 (0.18, 2.14) for an HFRS of 15. Conclusions: Frailty was associated with more conservative diabetes medication management following hypoglycaemia and hyperglycaemia admissions.
AB - Objective: To describe changes in glucose-lowering drug (GLD) dispensing by frailty status for people with diabetes following admission for hypoglycaemia or hyperglycaemia. Methods: This study included all people with probable type 2 diabetes in the state of Victoria, Australia, admitted to hospital for hypoglycaemia (n = 2,506 admissions) or hyperglycaemia (n = 1,693) between 1 July 2013 and 29 June 2017. Frailty was defined via the Hospital Frailty Risk Score (HFRS). We examined differences in dispensing of GLDs in the year before and after admission using linear regression models adjusted for age, sex, comorbidities, and socioeconomic status. Results: Dispensing of GLDs decreased following hypoglycaemia admission. Decreased dispensing was strongly associated with frailty status, with a change in mean annual GLD dispensing count of −4.11 (−5.05, −3.17) for an HFRS of 15 vs. −0.99 (−1.47, −0.50) for an HFRS of 0. Changes were greatest for metformin and sulfonylureas. Following hyperglycaemia admission, the mean number of annual GLD dispensings increased, with a smaller increase with increasing frailty: 2.44 (1.32, 3.56) for an HFRS of 0 vs. 1.16 (0.18, 2.14) for an HFRS of 15. Conclusions: Frailty was associated with more conservative diabetes medication management following hypoglycaemia and hyperglycaemia admissions.
UR - http://www.scopus.com/inward/record.url?scp=85185477597&partnerID=8YFLogxK
U2 - 10.1016/j.diabres.2024.111572
DO - 10.1016/j.diabres.2024.111572
M3 - Article
C2 - 38341041
AN - SCOPUS:85185477597
SN - 0168-8227
VL - 209
JO - Diabetes Research and Clinical Practice
JF - Diabetes Research and Clinical Practice
M1 - 111572
ER -
