Type 2 diabetes drug deprescribed in older people following UK review

Jack Woodfield
Thu, 12 Jul 2018
Type 2 diabetes drug deprescribed in older people following UK review
The type 2 diabetes drug class sulphonylureas was deprescribed in over 50% of older people with the condition following a review in West Hampshire, UK.

Sulphonylureas help to lower blood glucose levels by encouraging the body to secrete more insulin, and are recommended to those with type 2 diabetes who struggle to control their blood sugar levels.

In a new medication review of 618 people aged 75 or older with type 2 diabetes living in West Hampshire, the decision was made to cease sulphonylurea treatment in 255 patients, while 102 had their dose reduced.

The review was launched after a person with diabetes died in the area following a coma caused by hypoglycemia, of which the risk can be increased by sulphonylureas.

The pharmacy-led review was carried out among people living in the area covered by West Hampshire Clinical Commissioning Group (CCG).

Participants were identified following a trawl of patient registers at GP surgeries. All of them were treated with sulphonylureas and had HbA1c levels of under 53mmol/mol (7%).

The CCG carried out the work alongside the University Hospital Southampton NHS Foundation Trust as well as the Pre-registration Pharmacists at University Hospital Southampton.

Philip Newland-Jones, a diabetes consultant pharmacist, who was involved in the project, said: "Effective glycaemic control in type 2 diabetes reduces the risk of microvascular complications. However, the long-term benefits of tight glycaemic control in frail elderly patients are thought to be less than those for younger patients.

"This intervention by CCG practice-based pharmacists is a perfect example of the clinical work that pharmacists undertake on a daily basis that has a direct beneficial impact on patient care."

On the back of the reviews similar projects are also being launched across the country, including Devon.

Editor's note: Our Low Carb Program aims to help people with type 2 diabetes reduce dependence on diabetes medication by adopting a healthy, real food diet which can normalise blood sugar levels and enable weight loss. The program has demonstrated a cost saving of £835 per person per year for each person that completes the program through diabetes medication deprescription alone.
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