Deprescribing Glucose-Lowering Therapy in Older Adults with Diabetes: A Systematic Review of Recommendations

Overtreatment by glucose-lowering treatment (GLT) is frequent, and may induce harmful hypoglycemic events in older people with type 2 diabetes (T2D), significantly increasing morbidity and mortality. 1 Deng Z. Thompson W. Korenvain C. et al. Benefits and harms of deprescribing antihyperglycemics for adults with type 2 diabetes: A systematic review. Can J Diabetes. 2022; 46: 473-479 Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar Avoiding overtreatment by GLT, either by prescribing appropriate GLT according to their individual risks-benefits balance or by deprescribing GLT, is therefore a key issue in the management of older patients, as recommended by various scientific societies these last years. 2 Christiaens A. Henrard S. Zerah L. et al. Individualisation of glycaemic management in older people with type 2 diabetes: A systematic review of clinical practice guidelines recommendations. Age Ageing. 2021; 50: 1935-1942 Crossref PubMed Scopus (10) Google Scholar Nevertheless, there is currently no consensus on the definition of GLT overtreatment in older people, 3 Christiaens A. Henrard S. Boland B. et al. Overtreatment of older people with type 2 diabetes-a high impact frequent occurrence in need of a new definition. Diabet Med. 2022; 40: e14994 PubMed Google Scholar which prevents a clear statement on which patients should undergo deprescribing of GLT. It is therefore worthwhile to define the profiles of patients for whom GLT should be deprescribed. This systematic review of clinical practice guidelines (CPGs) aimed to compare the recommendations defining profiles of older patients in whom deprescribing GLT is recommended.