{"doi":"10.1111/jgs.19060","title":"Decline in use of high‐risk agents for tight glucose control among older adults with diabetes in New York City: 2017–2022","abstract":"BACKGROUND: This study aimed to examine the prevalence of inappropriate tight glycemic control in older adults with type 2 diabetes and other chronic conditions in New York City, and to identify factors associated with this practice. METHODS: We conducted a retrospective cohort study using the INSIGHT Clinical Research Network. The study population included 11,728 and 15,196 older adults in New York City (age ≥ 75 years) with a diagnosis of type 2 diabetes, and at least one other chronic medical condition, in 2017 and 2022, respectively. The main outcome of interest was inappropriate tight glycemic control, defined as HbA1c <7.0% (<53 mmol/mol) with prescription of at least one high-risk agent (insulin or insulin secretagogue). RESULTS: The proportion of older adults with inappropriate tight glycemic control decreased by nearly 19% over a five-year period (19.4% in 2017 to 15.8% in 2022). There was a significant decrease in insulin (27.8% in 2017; 24.3% in 2022) and sulfonylurea (29.4% in 2017; 21.7% in 2022) medication prescription, and increase in use of GLP-1 agonists (1.8% in 2017; 11.4% in 2022) and SGLT-2 inhibitors (5.8% in 2017; 25.1% in 2022), among the total population. Factors associated with inappropriate tight glycemic control in 2022 included history of heart failure (adjusted odds ratio [aOR] 1.38), chronic kidney disease ([aOR] 1.93), colorectal cancer ([aOR] 1.38), acute myocardial infarction ([aOR] 1.28), \"other\" ([aOR] 0.72) or \"unknown\" ([aOR] 0.72) race, and a point increase in BMI ([aOR] 0.98). CONCLUSIONS: We found an encouraging trend toward less use of high-risk medication strategies for older adults with type 2 diabetes and multiple chronic conditions. However, one in six patients in 2022 still had inappropriate tight glycemic control, indicating a need for continued efforts to optimize diabetes management in this population.","journal":"Journal of the American Geriatrics Society","year":2024,"id":480640,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8793,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1128777,"name":"Rania Kanchi","orcid":"0000-0001-7882-4550","position":1,"is_corresponding":false},{"id":774121,"name":"Sarah Conderino","orcid":"0000-0003-1762-9262","position":2,"is_corresponding":false},{"id":834189,"name":"Natalie Levy","orcid":"0000-0003-2956-5876","position":3,"is_corresponding":false},{"id":247795,"name":"Samrachana Adhikari","orcid":"0000-0001-9954-5999","position":4,"is_corresponding":false},{"id":449312,"name":"Saul Blecker","orcid":"0000-0003-4460-1046","position":5,"is_corresponding":false},{"id":276154,"name":"Nichola Davis","orcid":null,"position":6,"is_corresponding":false},{"id":342446,"name":"Jasmin Divers","orcid":"0000-0003-0120-7620","position":7,"is_corresponding":false},{"id":1268847,"name":"Catherine Rabin","orcid":null,"position":8,"is_corresponding":false},{"id":520533,"name":"Mark G. Weiner","orcid":"0000-0001-5586-9940","position":9,"is_corresponding":false},{"id":774122,"name":"Lorna E. Thorpe","orcid":"0000-0001-7515-0562","position":10,"is_corresponding":false},{"id":272504,"name":"John A. Dodson","orcid":"0000-0003-0163-3013","position":11,"is_corresponding":false},{"id":1320492,"name":"Jeff Zhang","orcid":null,"position":0,"is_corresponding":true}],"reference_count":23,"raw_metadata":null,"created_at":"2026-07-19T02:07:02.142014Z","pmid":"38980267","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}