• Eka Melson, Mohamed Fazil, Hnin Lwin, Anu Thomas, Ting Fong Yeo, Kevin Thottungal, HayMar Tun, Faseeha Aftab, Meri Davitadze, Alison Gallagher, Samuel Seidu, and Kath Higgins.
• Leicester Royal Infirmary, University Hospitals of Leicester NHS Foundation Trust, LE1 5WW, United Kingdom; Leicester Diabetes Centre, University of Leicester, LE5 4PW, United Kingdom. Electronic address: em524@leicester.ac.uk.
• Clin Med (Lond). 2024 Feb 20; 24 (2): 100029100029.

IntroductionThe community deintensification rates in older people with diabetes are low and hospital admission presents an opportunity for medication review. We audited the inpatient assessment and deintensification rate in people with diabetes and frailty. We also identified factors associated with adverse inpatient outcomes.MethodsA retrospective review of electronic charts was conducted in all people with diabetes and clinical frailty score ≥6 who were discharged from the medical unit in 2022. Data on demographics, comorbidities and background glucose-lowering medications were collected.ResultsSix-hundred-and-sixty-five people with diabetes and moderate/severe frailty were included in our analysis. For people with no HbA1c in the last six months preceding admission, only 9.0% had it assessed during inpatient. Deintensification rates were 19.1%. Factors that were associated with adverse inpatient outcomes included inpatient hypoglycaemia, non-White ethnicity, and being overtreated (HbA1c <7.0% [53 mmol/mol] with any glucose-lowering medication).ConclusionThe assessment and deintensification rate in secondary care for people with diabetes and frailty is low. Inpatient hypoglycaemia, non-White ethnicity, and overtreatment are important factors in determining inpatient outcomes highlighting the importance of deintensification and the need for an evidence-based risk stratification tool.Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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