• Ahmet Cigiloglu, Eyyup Murat Efendioglu, and Zeynel Abidin Ozturk.
• Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Gaziantep University, Sahinbey, Turkey.
• Postgrad Med. 2022 Sep 1; 134 (7): 693-697.

ObjectivesManagement of diabetes in elderly individuals requires a complex approach, considering the negative consequences. Glycemic overtreatment and undertreatment are relatively common conditions among this population. This study aimed to determine the potential overtreatment and undertreatment frequencies in older adults and the factors associated with these conditions.MethodsThis retrospective study included 405 diabetic older adults aged >65 years. Sociodemographic characteristics, additional comorbidities, medications, HbA1c and fasting glucose levels of the patients have been recorded.ResultsThe median age of the patients was 71 years. The frequency of potential overtreatment and undertreatment has been found to be 20.2% and 17.8%, respectively. Insulin and sulfonylureas were found to be associated with increased risk of potential overtreatment (p = 0.000, OR = 14.91 and p = 0.000, OR = 8.48, respectively) and reduced risk of potential undertreatment (p = 0.001, OR = 0.16 and p = 0.000, OR = 0.05, respectively), while DPP-4 inhibitors were found to be associated with reduced risk of potential undertreatment (p = 0.000, OR = 0.12).ConclusionOur study has shown that potential glycemic overtreatment and undertreatment are common problems in diabetic older adults. It was found that agents with a high risk of hypoglycemia, such as insulin and sulfonylureas, were more closely associated with potential overtreatment. In the management of diabetes in the elderly, it should be aimed to choose treatment agents that lead to less negative consequences and to follow up the patients more closely.

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