{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T08:03:36Z","timestamp":1771315416221,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:p>\n                    Polypharmacy is increasingly recognized as a relevant issue in diabetes care, but its prevalence and clinical relevance in individuals with type 1 diabetes remain underexplored. This study aimed to determine the prevalence of polypharmacy and to identify associated clinical and psychological factors. Participants were recruited from a tertiary diabetes outpatient clinic between February 2020 and April 2021. Polypharmacy was defined as the concurrent use of five or more medications, including insulin. Clinical, sensor\u2010based, and psychosocial data were collected. Logistic regression was used to identify variables independently associated with polypharmacy. A total of 484 individuals with type 1 diabetes were included (mean age 51.3\u2009\u00b1\u200915.9\u2009years; 51.2% male; median diabetes duration 30 [IQR 16\u201340] years; mean HbA\n                    <jats:sub>1c<\/jats:sub>\n                    60.3\u2009\u00b1\u200911.6\u2009mmol\/mol). Polypharmacy was present in 175 (36.2%) participants. Individuals with polypharmacy were more often female, were older, and had longer diabetes duration, higher BMI, higher HbA\n                    <jats:sub>1c<\/jats:sub>\n                    , more complications, and higher rates of hospital admission. They also were more likely to have impaired awareness of hypoglycemia and reported higher levels of fear of hypoglycemia with no differences in hyperglycemia\u2010related worry or behavior or diabetes\u2010related emotional distress. Polypharmacy affects over one\u2010third of individuals with type 1 diabetes and is associated with poorer health status and a greater hypoglycemia\u2010related burden. Future studies should investigate whether targeted medication review and psychological interventions may alleviate some of the burden in this high\u2010risk group.\n                  <\/jats:p>","DOI":"10.1002\/cpt.70130","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T10:39:01Z","timestamp":1762943941000},"page":"696-702","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Prevalence and Implications of Polypharmacy in Individuals With Type 1 Diabetes"],"prefix":"10.1002","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4302-7820","authenticated-orcid":false,"given":"Namam","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"van Erp","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5398-6414","authenticated-orcid":false,"given":"Cornelis","family":"Kramers","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Radboud University Medical Center  Nijmegen The Netherlands"},{"name":"Department of Pharmacy Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0322-1653","authenticated-orcid":false,"given":"Cornelis J.","family":"Tack","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Radboud University Medical Center  Nijmegen The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1255-7741","authenticated-orcid":false,"given":"Bastiaan E.","family":"de Galan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Radboud University Medical Center  Nijmegen The Netherlands"},{"name":"Department of Internal Medicine Maastricht University Medical Center+  Maastricht The Netherlands"},{"name":"CARIM School for Cardiovascular Disease Maastricht University  Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"e_1_2_12_1_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(22)00218-2"},{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1608664"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-71908-9"},{"key":"e_1_2_12_4_1","volume-title":"Medication Safety in Polypharmacy","author":"WHO","year":"2019"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-03279-x"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2019.10.022"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-021-05394-7"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.14406"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.15042"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.18.4.517"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.28.5.1245"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-009-1559-5"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc10-1343"},{"key":"e_1_2_12_14_1","doi-asserted-by":"crossref","unstructured":"Singh H.et al.Review assessing hyperglycemia avoidance in people with type 1 diabetes.4 263\u2013271(2014).","DOI":"10.2217\/dmt.14.3"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14685"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1590\/1413-81232018238.10222016"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-020852"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12497"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc24-0011"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2010.05.003"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2007.05.003"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2005.01644.x"},{"key":"e_1_2_12_23_1","first-page":"e31","article-title":"Use of continuous glucose monitoring leads to diagnosis of hemoglobin C trait in a patient with discrepant hemoglobin A1c and self\u2010monitored blood glucose","volume":"5","author":"Wright J.J.","year":"2019","journal-title":"AACE Clin Case Rep"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-038462"}],"container-title":["Clinical Pharmacology &amp; 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