TOPLINE

Among Danish care home residents with type 2 diabetes (T2D) admitted between 2018 and 2023, nearly 13% used glucose-lowering drugs at admission. The median A1c level was below the recommended target, but treatment intensity remained largely unchanged around admission, with limited deintensification.

METHODOLOGY

• Researchers in Denmark performed a nationwide cohort study using linked national registries to examine the use of glucose-lowering drugs among all individuals admitted to care homes from 2018 to 2023.
• The cohort included 88,658 residents (median age, 84 years; 60% women).
• Glucose-lowering drugs were classified as metformin, sulfonylureas, DPP-4 inhibitors, GLP-1 receptor agonists (RAs), SGLT2 inhibitors, basal insulin, bolus insulin, and other (glinides, thiazolidinediones, and acarbose); GLP-1 RAs marketed specifically for weight loss were excluded.
• The use of glucose-lowering drugs at admission was defined as at least one filled prescription in the 4 months before admission.
• The analysis assessed glucose-lowering drug treatment patterns, glycaemic control, persistence, and prescribing practices in the 2 years before and after care home admission.

TAKEAWAY

• Overall, 13% (n = 11,101) of residents used glucose-lowering drugs at admission, and 84% of them continued treatment beyond 2 years.
• At admission, the median diabetes duration was 12 years. Among residents on glucose‑lowering drugs, the median A1c level was 6.9% (52 mmol/mol) and changed little before or after admission, suggesting limited deintensification of treatment.
• Nearly half of the residents (43%) used multiple drug classes; metformin (70%), insulin (36%), and DPP‑4 inhibitors (19%) were most common. Although the use of either a GLP-1 RA or SGLT2 inhibitor increased over time — reaching 32% in 2023, up from 6.9% in 2018 — usage remained similar regardless of cardiorenal disease status (19% with cardiorenal disease vs 16% without).
• The initiation of glucose‑lowering drugs spiked in the 3 months before admission — about 36 new starts per 10,000 residents — and 63% occurred within 14 days of a hospital stay; most were bolus insulin prescriptions written by hospital physicians.

IN PRACTICE

"[The] patterns highlight the need for better evidence to support individualised, benefit-harm-balanced treatment decisions in this population," the authors wrote.

SOURCE

The study was led by Hanin Harbi, University of Southern Denmark, Odense, Denmark. It was published online on September 03, 2026, in Diabetes, Obesity and Metabolism.

LIMITATIONS

The study relied on filled prescription records; therefore, it could not confirm that medications were actually taken or why they were prescribed. Some glucose-lowering drugs may have been used for reasons other than T2D, and the researchers could not fully rule out this misclassification. They also lacked data on hypoglycaemia, patient treatment goals or preferences, contraindications, and the clinical reasons behind treatment choices.

DISCLOSURES

This study was supported by a grant from Steno Diabetes Center Odense, which was funded by the Novo Nordisk Foundation. Some authors reported receiving institutional research support, and one author had given occasional presentations for pharmaceutical companies and worked at a department that received institutional research grants.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.