{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T11:10:20Z","timestamp":1788952220504,"version":"build-2803163510"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Type 2 diabetes mellitus is highly prevalent among older adults and associated with frailty, functional decline, and increased healthcare utilization. Evidence on metabolic control and therapeutic management in hospitalized nonagenarians remains scarce, particularly in low- and middle-income country settings. This study aimed to describe glycated hemoglobin (A1c) and antidiabetic treatment modifications during hospitalization in nonagenarians with type 2 diabetes, within the context of their clinical, functional, and geriatric characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>A descriptive, retrospective, cross-sectional study based on an institutional registry from the geriatric service of a high-complexity hospital in Bogot\u00e1, Colombia (2022\u20132024). Individuals aged \u226590\u202fyears with a history of type 2 diabetes mellitus documented at admission were included. A1c values, antidiabetic treatment at admission and discharge and geriatric characteristics were analyzed descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 195 nonagenarians, mean age was 92\u202f\u00b1\u202f2\u202fyears and 60.00% were women. Infectious conditions were the most frequent admission diagnoses. Median Barthel Index score was 55 points (IQR 20\u201380); frailty (CFS\u202f\u2265\u202f5) was identified in 89.20%, delirium at admission in 39.49%, and major neurocognitive disorder in 16.41%. Of patients with formal nutritional assessment (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f103), 52.43% had moderate-to-severe malnutrition. Polypharmacy was present in 80.00%, with a median of 7 medications (IQR 5\u20139). Despite this clinical burden, 74.38% of patients with available A1c (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f121) had values &amp;lt;7.5%, suggesting potential overtreatment. At discharge, the proportion without antidiabetic pharmacological treatment increased from 26.15 to 46.20%, with reductions in metformin, DPP-4 inhibitors, and insulin prescriptions, and an increase in SGLT-2 inhibitor use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The coexistence of low A1c values and high burden of frailty, malnutrition, and polypharmacy reveals a critical discordance between therapeutic intensity and clinical status. These findings highlight a gap in ambulatory therapeutic review and support the need for individualized goals, deprescription protocols, and interdisciplinary care models bridging hospital, community, and domiciliary settings, a public health priority for aging populations in Latin America.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1900588","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T10:16:20Z","timestamp":1788948980000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Glycated hemoglobin (A1c) values and antidiabetic treatment deprescription in hospitalized nonagenarians with type 2 diabetes"],"prefix":"10.3389","volume":"14","author":[{"given":"Elly","family":"Morros-Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"Departamento de Cl\u00ednicas M\u00e9dicas, Instituto M\u00e9deri del Envejecimiento y Longevidad, Hospital Universitario Mayor-M\u00e9deri, Universidad del Rosario","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola Andrea","family":"Trivi\u00f1o-Bele\u00f1o","sequence":"additional","affiliation":[{"name":"Facultad de Medicina, Universidad El Bosque","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily Sharlot","family":"Villamizar","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud de la Universidad Aut\u00f3noma de Bucaramanga","place":["Bucaramanga, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Torres-Arias","sequence":"additional","affiliation":[{"name":"Departamento de Cl\u00ednicas M\u00e9dicas, Hospital Universitario Mayor-M\u00e9deri, Universidad del Rosario","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1ngela","family":"Marriaga-\u00c1ngel","sequence":"additional","affiliation":[{"name":"Departamento de Cl\u00ednicas M\u00e9dicas, Instituto M\u00e9deri del Envejecimiento y Longevidad, Hospital Universitario Mayor-M\u00e9deri, Universidad del Rosario","place":["Bogot\u00e1, Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref1","year":"2025"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1177\/0898264305285728","article-title":"The prevalence of diagnosed diabetes among the elderly of seven cities in Latin America and the Caribbean: the health wellbeing and aging (SABE) project","volume":"18","author":"Barcel\u00f3","year":"2006","journal-title":"J Aging Health"},{"key":"ref3","first-page":"1","volume-title":"Encuesta SABE Colombia: situaci\u00f3n de salud, bienestar y envejecimiento en Colombia","year":"2016"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"230","DOI":"10.36104\/amc.2017.942","article-title":"Anciano con Diabetes y factores asociados","volume":"42","author":"Morros-Gonz\u00e1lez","year":"2017","journal-title":"Acta Med Col"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"8677","DOI":"10.3390\/ijerph19148677","article-title":"Management of Type 2 diabetes mellitus in elderly patients with frailty and\/or sarcopenia","volume":"19","author":"Sanz-C\u00e1novas","year":"2022","journal-title":"IJERPH"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"404","DOI":"10.53853\/encr.8.4.715","article-title":"Fragilidad en personas mayores con diabetes: revisi\u00f3n narrativa del tema","volume":"8","author":"Morros-Gonz\u00e1lez","year":"2022","journal-title":"RevACE"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1263650","DOI":"10.3389\/fendo.2023.1263650","article-title":"Pathogenesis and comprehensive treatment strategies of sarcopenia in elderly patients with type 2 diabetes mellitus","volume":"14","author":"Hou","year":"2024","journal-title":"Front Endocrinol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"S277","DOI":"10.2337\/dc26-S013","article-title":"13. 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