Observational studyDiabetes care2025
Prescribing Trends of Glucose-Lowering Medications Near End of Life Among Adults With Type 2 Diabetes: A Cohort Study.
Observational study in Diabetes care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
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Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectiveTo assess prescribing trends of glucose-lowering medications in the last year of life among older adults with type 2 diabetes (T2D) and explore whether frailty is associated with differential prescribing. RESEARCH DESIGN AND
methodsIn this observational cohort study of Medicare beneficiaries aged ≥67 years (2015-2019) with T2D, we assessed temporal trends in prescribing a glucose-lowering medication, stratified by frailty. The main outcome included glucose-lowering medication fills within 1 year of death.
resultsAmong 975,407 community-dwelling Medicare beneficiaries with T2D, the use of glucose-lowering medications within 1 year of death slightly increased from 71.4% during the first 6-month period in 2015 to 72.9% (standardized mean difference [SMD] -0.03) during the second 6-month period in 2019. The most pronounced increase in use was observed for metformin (40.7% to 46.5%, SMD -0.12), whereas the largest decrease was observed for sulfonylureas (37.0% to 31.8%, SMD 0.11). Overall glucose-lowering medication use decreased from 66.1% in the 9 to 12 months before death to 60.8% in the last 4 months of life (SMD 0.11; P < 0.01), driven by reduced noninsulin medication use. The use of short-acting and long-acting insulin both increased near death, with frailer individuals more likely to receive insulin. Sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists, although less common, became more frequent in more recent years.
conclusionsThe use of glucose-lowering medications declined in the last year of life, mainly due to reduced noninsulin use. Insulin use increased near death, particularly among frailer individuals, highlighting the need for careful end-of-life management.
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