{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T19:04:57Z","timestamp":1757617497280,"version":"3.44.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Hypoglycaemic drugs (sulfonylureas, glinides or insulins) are commonly prescribed for older adults with type 2 diabetes (T2D) but may carry risks of adverse events. Whether de-intensifying hypoglycaemic drugs is associated with clinical benefit in older adults remains unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the association between de-intensification of hypoglycaemic drugs and clinical outcomes in older adults with T2D.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Cohort study conducted with the target trial emulation approach, using data collected from 2000 French general practises between January 2010 and February 2019 (The Health Improvement Network\u2014THIN database). Eligible participants were \u226575\u00a0years old, on stable hypoglycaemic drugs (no change in drug or dose) for at least 6\u00a0months, and had an HbA1c value &amp;lt;9%. Hypoglycaemic drug de-intensification (exposure) was defined as cessation or reduction of \u226550% of total dose. The primary outcome was a composite measure of all-cause death or hospital admissions within 3\u00a0months, and its association with exposure was assessed using multivariable logistic regression adjusted for potential baseline confounders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The study included 14\u00a0383 unique individuals corresponding to 177\u00a0314 trial emulation participants (mean age 80\u00a0years; 44.7% female). Of these, 6480 participants were allocated to de-intensification group, and 170\u00a0834 to the control group. At 3\u00a0months, the primary outcome occurred in 3.96% of the de-intensification group and 2.99% of controls [adjusted relative risk, 1.33 (95% CI, 1.22\u20131.43)]. Subgroup analyses showed consistent associations across most participants\u2019 profiles.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In older adults with T2D, de-intensification of hypoglycaemic drugs was associated with a higher short-term risk of all-cause death or hospitalisation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afaf160","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T15:03:24Z","timestamp":1749654204000},"source":"Crossref","is-referenced-by-count":1,"title":["Association between hypoglycaemic drug de-intensification, mortality and hospital admission in older adults with type 2 diabetes: a cohort study emulating a target 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Medicine Unit, Cliniques universitaires Saint-Luc , Brussels ,","place":["Belgium"]},{"name":"Institute of Health and Society, Universit\u00e9 catholique de Louvain , Brussels ,","place":["Belgium"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yannis","family":"Slaouti-J\u00e9gou","sequence":"additional","affiliation":[{"name":"RESIP, Claude Bernard, Boulogne-sur-mer ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B\u00e9ranger","family":"Lekens","sequence":"additional","affiliation":[{"name":"RESIP, Claude Bernard, Boulogne-sur-mer ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominique","family":"Bonnet-Zamponi","sequence":"additional","affiliation":[{"name":"Observatoire des m\u00e9dicaments, dispositifs m\u00e9dicaux, innovations th\u00e9rapeutiques d\u2019\u00cele-de-France Paris, Ile de france ,","place":["France"]},{"name":"Pierre Louis Institute of Epidemiology and Public Health, INSERM, Sorbonne Universit\u00e9, Paris, \u00cele-de-France ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"No\u00e9mie","family":"Simon-Tillaux","sequence":"additional","affiliation":[{"name":"Oncostat U1018, INSERM, Universit\u00e9 Paris-Saclay, Villejuif, \u00cele-de-France ,","place":["France"]},{"name":"Bureau de Biostatistique et d'\u00c9pid\u00e9miologie Gustave Roussy, Universit\u00e9 Paris-Saclay, Villejuif, \u00cele-de-France ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3474-2200","authenticated-orcid":false,"given":"Lorene","family":"Zerah","sequence":"additional","affiliation":[{"name":"D\u00e9partement de g\u00e9riatrie, Piti\u00e9-Salp\u00eatri\u00e8re University Hospital, Assistance Publique-Hopitaux de Paris , Paris ,","place":["France"]},{"name":"Pierre Louis Institute of Epidemiology and Public Health, INSERM, Sorbonne Universit\u00e9, Paris, 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