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Chaudhry SI, Berlowitz DR, Concato J. Do age and comorbidity affect intensity of pharmacological therapy for poorly controlled diabetes mellitus? Journal of the American Geriatrics Society. 2005 Jul 1; 53(7):1214-6.
OBJECTIVES: To examine the influence of age and comorbidity on intensification of medical therapy for patients with poorly controlled diabetes mellitus (DM). DESIGN: Observational cohort study using data from Department of Veterans Affairs (VA) national databases. SETTING: Thirteen VA medical centers in New England, Florida, and Puerto Rico. Participants: Veterans (N = 5,317) with poorly controlled DM receiving regular medical care MEASUREMENTS: An increase in hypoglycemic medications, or intensification of therapy, was considered present at the visit if a new hypoglycemic medication was started or the dosage of an existing medication was increased. RESULTS: The overall rate of intensification of therapy was 20.8% (1,106/5,317). The rate of intensification was highest in the youngest patients without comorbidity (24.5%) and lowest in the oldest patients with comorbidity (15.7%) (P < .001). CONCLUSION: Rates of intensification at a single clinic visit were quite low in all groups and were lowest in older patients with comorbidity.