Diabetic Older Adults: Drug Use and Interactions

According to a recent study by Brazilian investigators, there is a need for more health education on non-drug practices, in terms of primary care, that will benefit diabetic older adults as well as more patient awareness of non-drug treatments.

A team of researchers from Cidade Universitária (Brazil), led by Marilisa Berti de Azevedo Barros, sought to outline the sociodemographic and health profile of older adults with diabetes to assess the knowledge and practices regarding treatment options and describe the use of medications and potential risks for drug interactions (DI) in this subgroup.

In 2008, a cross-sectional study was conducted of 1517 citizens (aged 60 and older) in Campinas where the prevalence of diabetes was estimated and its associations assessed using the Rao-Scott test (P < .05). The potential DIs were evaluated using the Micromedex® database. Diabetes prevalence was 21.7%, without significant difference between the sexes.
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Among the elderly diabetics interviewed who reported use of 2 or more medicines (n = 299), 413 potential DIs were reported, with 53.1%, 7.8%, and 7.2% of them featuring risk of moderate, lesser, and serious interactions, respectively, and 31.9% not featuring any interaction possibility at all. 

For controlling diabetes, the chief strategies reportedly used were as follows: routine use of oral medication and insulin, as well as following a regular food diet. Participation in discussion groups on the subject of the disease was infrequent (10.4%) and complications resulting from diabetes were reported by 37.3% of people interviewed.

In relation to the evaluation of diabetes management knowledge of respondents, besides routine use of oral medication, three key factors were frequently mentioned by the interviewees: regular healthy diet, physical activity, and other such practices in order to lose/maintain weight.

The authors concluded that older adults with diabetes should be given more specialized treatment and made more aware of various treatment strategies. In addition, providers should pay increased attention to the potential risk of drug interactions. —Amanda Del Signore