The Impact of Geriatric Assessment on the Treatment Plan of Elderly Patients With Type 2 Diabetes Mellitus: a Randomized Clinical Trial.

What this Trial Is About

Researchers are investigating the impact of geriatric assessment on treatment plans for elderly patients with type 2 diabetes mellitus (T2DM). This randomized clinical trial aims to address the rising number of older adults living with T2DM and the need for individualized glycemic targets to improve health outcomes and reduce risks such as sarcopenia, frailty, immobility, infections, and hypoglycemia. The study evaluates how providing geriatric assessment information to physicians influences their therapeutic decisions in elderly patients with T2DM. Participants aged 60 and older with T2DM will undergo geriatric assessments using the Clinical Frailty Scale (CFS) and the 10-minute Targeted Geriatric Assessment (TaGA-10). Patients are randomized into two groups: the control group receives usual treatment without additional intervention, while the intervention group’s physicians receive a note suggesting glycemic targets based on the patient's frailty status (functionally independent, functionally dependent, or frail). The suggested targets range from HbA1c around 7.0% for independent patients to less strict goals for frail patients, following Diabetes Canada guidelines. During the study, participants will be assessed at baseline and followed up by telephone at 3 and 6 months to monitor hypoglycemia, falls, infections, hospitalizations, and mortality. The primary outcome is the adequacy of hyperglycemia treatment measured within one week after randomization. Secondary outcomes include changes in glycemic control and other health events. Data will be collected from medical records and interviews, anonymized, and analyzed to determine the clinical impact of geriatric assessment on treatment decisions and patient health over time.

The Impact of Geriatric Assessment on the Treatment Plan of Elderly Patients With T2DM