The impact of oral antidiabetics on weight in the elderly with ype 2 Diabetes mellitus in the ambulatory setting

Comparison of data gathered in an electronic medical record (EMR) database on Type 2 Diabetes Mellitus (T2DM) patients age 65 years and older with oral antidiabetics (OAD) agent prescription and recorded body mass index (BMI)/weight was performed. A retrospective review of the General Electric Centricity Medical Quality Improvement Consortium (MQIC) research database containing the ambulatory health records of US patients was conducted. T2DM patients age 65 and older were identified by diagnosis, OAD prescription or both. Sixmonths of continuous OAD activity was required; 395 days pre-index-date (index datewas defined by first OAD prescription) clinical activity was required. Two BMI and weight readings were mandated, at baseline, closest to index date and follow-up, closest to 6 months after initiation of OAD activity. A historical, longitudinal cohort design was used and data were analyzed using analysis of variance (ANOVA) with Tukey test for adjustment of the differences in the means between the groups for continuous variables; Pearson's Chi-square test was used to test association for categorical variables. The overall mean age for all of the OAD groups was 72.7 years. The values of the baseline diastolic blood pressure (DBP) differed (p=0.0009), as well as age (p< 0.001); DBP indicated patients were in Hypertension Stage 1. The baseline A1C level was shown to be statistically significant between the groups (p< 0.001) with the highest mean value in sulfonylureas group (7.7). Significant differences between the OAD groups were also found in respect to race and smoking status (p=0.004 and < 0.0001). In comparison between the baseline and the follow-up values, statistical significance was found in both of the outcomes and a drop of 0.7 BMI units was initiated among all of the OAD groups. The overall mean BMI value among all of the OAD groups was 29.08 kg/m². The change in BMI after 6 months of monotherapy demonstrated that meglitinides had the biggest decrease in BMI (-1.27), followed by the metformin group (-1.06) and the sulfonylureas showed the least BMI drop (-0.14). Weight as the secondary outcome variable demonstrated an average 3.97 lb weight loss between all of the OAD groups. Major weight loss was found in the meglitinides users (-7.82lb), pursued by the metformin group (-6.41lb); the sulfonylureas group reported the least weight loss (-0.89lb). EMR data demonstrated an association between the OAD user and BMI/weight and associated conditions consistent with elderly T2DM patients in a real-world setting. The likelihood of weight loss was somewhat consistent with the previous literature, except in the case of the TZD group, where the literature showed the expected weight gain and this study does not support these findings.