1885-LB: Status of Irrational Prescription of Oral Antidiabetic Drugs (OADs) Based on eGFR in Elderly Type 2 Diabetes Patients and the Related Affecting Factors

Objective: To explore the current status of irrational prescription of OADs in elderly T2D patients based on eGFR and the related affecting factors.

Methods: Data from 219 patients over 65 years old with established T2D and treated on OADs who admitted to our department in 2023 were retrospectively analyzed. The irrational prescription was defined as the doses of OADs were not reduced or OADs were not discontinued based on eGFR level before admission. The patients were therefore divided into the rational prescription (RP) or irrational prescription (IRP) group. The clinical characteristics were compared between groups, and the related affecting factors for irrational prescription were analyzed with multivariate logistic regression model.

Results: Among these patients [mean age: 72.2 years old; mean duration of diabetes: 11.3 years; mean HbA1c: 7.8%; 46 (21%) with eGFR<60 ml/(min·1.73m²) ], the most frequently used OADs were biguanides (80.4%) and sulfonylureas (43.8%). And 37 (17%) patients were in the IRP group. Compared with the RP group, patients in the IRP group had higher serum creatinine (144.3±45.8 vs. 67.6±20.4 umol/L, P<0.001), lower eGFR [39.3±12.4 vs. 85.0±14.2ml/(min·1.73m²), P <0.001], and treated with more OADs (2.2±0.8 vs. 1.9±0.7, P<0.05). Multivariate logistic regression model showed that the number of OADs (OR: 4.14, P<0.05) and eGFR (OR: 0.802, P<0.001) were the affecting factors for irrational prescription.

Conclusions: The irrational prescription of OADs were common in elderly T2D patients. The number of OADs used and lower eGFR were the risk factors accounting for the irrational prescription in this papulation.