{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T12:26:59Z","timestamp":1774009619022,"version":"3.50.1"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,8,8]],"date-time":"2017-08-08T00:00:00Z","timestamp":1502150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2018,1]]},"abstract":"\n Aims<\/jats:title>\n \n To compare the glycaemic outcomes of 2 glucose\u2010lowering treatment strategies in vulnerable (moderately ill and\/or frail) patients aged \u226565\u2009years with type 2 diabetes whose individual HbA1c targets were not met with diet\/exercise and\/or oral anti\u2010hyperglycaemic medications (\n OAM<\/jats:styled-content>\n s).\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n The primary endpoint of this study was a composite of achieving\/maintaining individualized HbA1c targets without \u201cclinically significant\u201d hypoglycaemia (severe hypoglycaemia or repeated hypoglycaemia causing interruption of patients\u2019 activities or blood glucose <54\u2009mg\/dL). Strategy\u2010\n A<\/jats:styled-content>\n comprised glucose\u2010dependent therapies (\n n<\/jats:italic>\n \u2009=\u200999) with a non\u2010sulphonylurea\n OAM<\/jats:styled-content>\n and a glucagon\u2010like peptide\u20101 receptor agonist as the first injectable. Strategy\u2010\n B<\/jats:styled-content>\n comprised non\u2010glucose\u2010dependent therapies (\n n<\/jats:italic>\n \u2009=\u200993) with sulphonylurea as the preferred\n OAM<\/jats:styled-content>\n and insulin glargine as the first injectable.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n There was no significant difference between Strategy\u2010\n A<\/jats:styled-content>\n and Strategy\u2010\n B<\/jats:styled-content>\n in percentages of patients achieving the primary endpoint (64.5% vs 54.9%;\n P<\/jats:italic>\n \u2009=\u2009.190). Mean incidences (\n A<\/jats:styled-content>\n vs\n B<\/jats:styled-content>\n ) of total (10.2% vs 53.8%), documented symptomatic (5.1% vs 36.6%), and asymptomatic (8.2% vs 32.3%) hypoglycaemia were lower for Strategy\u2010\n A<\/jats:styled-content>\n (\n P\u2009<<\/jats:italic>\n \u2009.001 each). Proportions of patients achieving\/maintaining HbA1c target (\n A<\/jats:styled-content>\n , 63.3% vs\n B<\/jats:styled-content>\n , 55.9%) were similar.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Similar proportions of older, vulnerable aged \u226565\u2009years patients with type 2 diabetes achieved\/maintained glycaemic treatment goals without clinically significant hypoglycaemia with Strategies A or B. However, Strategy\u2010A resulted in lower risk of total, documented symptomatic, and asymptomatic hypoglycaemia. These results identify an approach of potential clinical benefit in this age group and will inform future clinical research in older patients with type 2 diabetes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/dom.13051","type":"journal-article","created":{"date-parts":[[2017,7,3]],"date-time":"2017-07-03T09:56:41Z","timestamp":1499075801000},"page":"148-156","source":"Crossref","is-referenced-by-count":15,"title":["Glycaemic outcomes of an\n I<\/scp>\n ndividualized treat\n M<\/scp>\n ent a\n P<\/scp>\n proach for old\n ER<\/scp>\n vulnerable pat\n I<\/scp>\n ents:\n A<\/scp>\n randomized, controlled st\n U<\/scp>\n dy in type 2 diabetes\n M<\/scp>\n ellitus (\n IMPERIUM<\/scp>\n )"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2425-9565","authenticated-orcid":false,"given":"Simon R.","family":"Heller","sequence":"first","affiliation":[{"name":"University of Sheffield Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard E.","family":"Pratley","sequence":"additional","affiliation":[{"name":"Florida Hospital and Sanford Burnham Prebys Translational Research Institute Orlando Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Sinclair","sequence":"additional","affiliation":[{"name":"Foundation for Diabetes Research in Older People, Diabetes Frail Limited Droitwich UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Festa","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company Vienna Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacek","family":"Kilja\u0144ski","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company Warsaw Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cynthia S.","family":"Brusko","sequence":"additional","affiliation":[{"name":"Lilly USA, LLC Indianapolis Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ran","family":"Duan","sequence":"additional","affiliation":[{"name":"Lilly USA, LLC Indianapolis Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert J.","family":"Heine","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company Indianapolis Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,8,8]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation","year":"2015"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2337\/diaspect.19.4.221"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2007.35"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2011.10.029"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61676-1"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(14)70176-7"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-2441"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.404"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-1801"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002512-200421080-00003"},{"key":"e_1_2_6_12_1","first-page":"1963","article-title":"Achieving glycemic control in elderly patients with type 2 diabetes: a critical comparison of current options","volume":"9","author":"Du YF","year":"2014","journal-title":"Clin Interv Aging"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP13192.RA"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2012.04.012"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0806470"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc15-0187"},{"key":"e_1_2_6_17_1","unstructured":"International Diabetes Federation. 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