Evidence mapPaperPMID 40241469Full record

SynthesisGeriatrics & gerontology international2025

Diabetes medication management recommendations for older adults: A systematic review of the Western Pacific region.

Darshna Goordeen, J Simon Bell, Youmna Elsedfy, Soroush Fariman, Shota Hamada, Yukari Hattori, Kate Wang, Majd Abu Al Shieh, Michael Nunan, Joshua D Niznik and 1 more

Abstract readSystematic Review
In one paragraph

Synthesis in Geriatrics & gerontology international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Darshna GoordeenCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.ORCID https://orcid.org/0000-0002-6381-8745
J Simon BellCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.ORCID https://orcid.org/0000-0002-6115-2767
Youmna ElsedfySchool of Pharmacy, University of Queensland, Brisbane, Australia.ORCID https://orcid.org/0009-0007-0678-7616
Soroush FarimanDivision of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID https://orcid.org/0000-0002-6193-9578
Shota HamadaResearch Department, Institute for Health Economics and Policy, Association for Health Economics Research and Social Insurance and Welfare, Tokyo, Japan.ORCID https://orcid.org/0000-0003-4939-1834
Yukari HattoriDepartment of Home Care Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Kate WangSchool of Health and Biomedical Sciences, RMIT University, Melbourne, Australia.ORCID https://orcid.org/0000-0001-5208-1090
Majd Abu Al ShiehCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
Michael NunanBeyond Essential Systems, Melbourne, Australia.
Joshua D NiznikDivision of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID https://orcid.org/0000-0003-1466-5751
Emily ReeveCentre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.ORCID https://orcid.org/0000-0002-1405-999X

Funding

Monash UniversityPharmAlliance Research Clusters for Doctoral TrainingThe University of North Carolina at Chapel HillUniversity College London
6 · The paper itself

Abstract

aimThe Western Pacific region has the fastest aging population and 38% of the world's diabetes population. It is unknown to what extent medication management recommendations are included for older adults in type 2 diabetes (T2D) clinical practice guidelines (CPGs).

methodMEDLINE, Embase, Scopus, guideline-specific registries and gray literature searches were performed in November 2024. Data were extracted on guideline characteristics and recommendations relevant to older adults, dementia, frailty, co-morbidities associated with aging or end-of-life. Quality appraisal was performed using the AGREE II (Appraisal of Guidelines, Research and Evaluation) tool.

resultsFrom the 37 countries and areas of the Western Pacific region, 16 CPGs were identified, of which 15 included 1-29 relevant recommendations. Thirteen CPGs recommended less stringent and/or individualized glycemic targets focused on reducing hypoglycemia for older adults. Five CPGs recommended individualized antihyperglycemic treatment choices. Seven CPGs included recommendations about de-intensification/simplification of complex regimens. The quality of CPGs varied, with scope and purpose rated the highest.

conclusionsThere was heterogeneity in the number of recommendations within CPGs; however, none comprehensively addressed the T2D medication management needs of older adults or those living with dementia, frailty or receiving end-of-life care. Collaboration between diabetes and geriatric societies as well as the assistance of higher-income countries in helping those with less resource availability could provide a way forward to improving future CPGs. Geriatr Gerontol Int 2025; 25: 717-729.

Indexed as

Diabetes Mellitus, Type 2Hypoglycemic AgentsPractice Guidelines as TopicAgedAged, 80 and overHumansHypoglycemic Agentsagedantihyperglycemicdiabetes mellituspractice guideline

Identifiers

PMID40241469
PMCPMC12170965

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.