Prescribing Trends of Glucose-Lowering Medications Near End of Life Among Adults With Type 2 Diabetes: A Cohort Study
Authors' conclusion
The 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.
Study context
- Population
- Community-dwelling Medicare beneficiaries aged ≥67 years with T2D (2015–2019), in the last year of life
- Participants
- 975,407 beneficiaries
- Exposure
- Prescribing trends over time (2015–2019) and by time before death, stratified by frailty
- Outcome
- Glucose-lowering medication fills
- Follow-up
- Within 1 year of death
Methodological detailsobservational, Medicare beneficiaries, stratified by frailty
- Observational
- Medicare beneficiaries
- Stratified by frailty
Main finding
As reported in the abstract
Use of glucose-lowering medications within 1 year of death · first 6-month period 2015 to second 6-month period 2019
Use in first 6-month period of 2015
71.4%
Use in second 6-month period of 2019 (slight increase)
72.9%
SMD
−0.03
Observational data: associations, not effects.
Further findings
Metformin use, 2015 to 2019
- Most pronounced increase: metformin
- 40.7% to 46.5%
- SMD
- −0.12
SU use, 2015 to 2019
- Largest decrease: SU
- 37.0% to 31.8%
- SMD
- 0.11
Overall glucose-lowering medication use, 9–12 months before death to last 4 months of life
- Decrease, driven by reduced noninsulin use
- 66.1% to 60.8%
- SMD 0.11
- P < 0.01
Insulin use near death
- Short-acting and long-acting insulin use both increased near death; frailer individuals more likely to receive insulin
SGLT2i and GLP-1 RA use
- Less common, but more frequent in more recent years
Original publication
Prescribing Trends of Glucose-Lowering Medications Near End of Life Among Adults With Type 2 Diabetes: A Cohort Study. Diabetes Care. Published 2 January 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →