Objectives: To examine the influence of age and comorbidity on intensification of medical therapy for patients with poorly controlled diabetes mellitus (DM).
Design: Observational cohort study using data from Department of Veterans Affairs (VA) national databases.
Setting: Thirteen VA medical centers in New England, Florida, and Puerto Rico.
Participants: Veterans (N=5,317) with poorly controlled DM receiving regular medical care
Measurements: An increase in hypoglycemic medications, or intensification of therapy, was considered present at the visit if a new hypoglycemic medication was started or the dosage of an existing medication was increased.
Results: The overall rate of intensification of therapy was 20.8% (1,106/5,317). The rate of intensification was highest in the youngest patients without comorbidity (24.5%) and lowest in the oldest patients with comorbidity (15.7%) (P<.001).
Conclusion: Rates of intensification at a single clinic visit were quite low in all groups and were lowest in older patients with comorbidity.