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Peer-reviewedCC BY-NC 4.0Diabetes, Obesity & Metabolism

Use of Glucose‐Lowering Drugs for Type 2 Diabetes Among Danish Care Home Residents

  • Hanin Harbi1,2,3
  • Reimar W. Thomsen4
  • Carina Lundby1,2
  • Jacob Volmer Stidsen3,5
  • Kurt Højlund3,5
  • Jesper Ryg6,7,8
  • Mette Reilev1,9,10
  • Anton Pottegård1,2
10 affiliations
  1. 1Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health University of Southern Denmark Odense Denmark
  2. 2Hospital Pharmacy Funen Odense University Hospital Odense Denmark
  3. 3Steno Diabetes Center Odense Odense University Hospital Odense Denmark
  4. 4Department of Clinical Epidemiology Aarhus University and Aarhus University Hospital Aarhus Denmark
  5. 5Department of Clinical Research University of Southern Denmark Odense Denmark
  6. 6Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
  7. 7Geriatric Research Unit, Department of Clinical Research University of Southern Denmark Odense Denmark
  8. 8Geriatric Research and Clinical Evidence, Department of Internal Medicine Copenhagen University Hospital Herlev Denmark
  9. 9Centre for Suicide Research Odense Denmark
  10. 10Unit of Mental Health Research, Southwest Denmark, Department of Psychiatry Aabenraa Region of Southern Denmark Denmark
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Abstract

Aims: Care home admission often reflects frailty and limited life expectancy, potentially altering the benefit‐harm balance of glucose‐lowering drug (GLD) treatment for type 2 diabetes (T2D). Real‐world data on treatment patterns in this setting remain limited. We examined GLD use for T2D among Danish care home residents.

Materials and Methods: We conducted a nationwide, population‐based drug utilisation study of all individuals admitted to Danish care homes between 2018 and 2023, using linked national health registries.

Results: Among 88 658 residents (median age: 84 years [IQR: 78–90]; 60% women), 13% (n = 11 101) used GLDs for T2D at admission, with 84% continuing treatment beyond 2 years. Residents using GLDs at admission had long‐standing diabetes (median duration: 12 years [IQR: 6.8–15]), relatively low glycated haemoglobin levels (median: 6.9% [IQR: 6.3–7.8]; 52 mmol/mol [45–62]) with little change around admission, and 43% used more than one GLD class, most commonly metformin (70%) and insulin (36%; basal: 30%; bolus: 16%). Use of glucagon‐like peptide‐1 receptor agonists and sodium‐glucose cotransporter‐2 inhibitors increased over time but remained limited (13% and 24%, respectively, in 2023), despite a high prevalence of cardiorenal disease (84%), and did not differ by cardiorenal disease status. Overall GLD use remained stable around admission, but initiation spiked 3 months before admission (36 initiators/10 000 residents), often following hospitalisation (63%) and primarily involved bolus insulin initiated by hospital physicians.

Conclusions: GLD use for T2D among Danish care home residents is high and shows limited deintensification and potential misalignment with guideline recommendations.

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Cite

BibTeXRIS
BibTeX
@article{harbi2026glucoselowering,
  title = {{Use of Glucose‐Lowering Drugs for Type 2 Diabetes Among Danish Care Home Residents}},
  author = {Hanin Harbi and Reimar W. Thomsen and Carina Lundby and Jacob Volmer Stidsen and Kurt Højlund and Jesper Ryg and Mette Reilev and Anton Pottegård},
  journal = {Diabetes, Obesity \& Metabolism},
  year = {2026},
  month = sep,
  doi = {10.1111/dom.71308},
  url = {https://doi.org/10.1111/dom.71308},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Use of Glucose‐Lowering Drugs for Type 2 Diabetes Among Danish Care Home Residents
AU  - Hanin Harbi
AU  - Reimar W. Thomsen
AU  - Carina Lundby
AU  - Jacob Volmer Stidsen
AU  - Kurt Højlund
AU  - Jesper Ryg
AU  - Mette Reilev
AU  - Anton Pottegård
PY  - 2026
DA  - 2026/09/03
JO  - Diabetes, Obesity & Metabolism
DO  - 10.1111/dom.71308
UR  - https://doi.org/10.1111/dom.71308
AB  - Aims: Care home admission often reflects frailty and limited life expectancy, potentially altering the benefit‐harm balance of glucose‐lowering drug (GLD) treatment for type 2 diabetes (T2D). Real‐world data on treatment patterns in this setting remain limited. We examined GLD use for T2D among Danish care home residents.  Materials and Methods: We conducted a nationwide, population‐based drug utilisation study of all individuals admitted to Danish care homes between 2018 and 2023, using linked national health registries.  Results: Among 88 658 residents (median age: 84 years [IQR: 78–90]; 60% women), 13% (n = 11 101) used GLDs for T2D at admission, with 84% continuing treatment beyond 2 years. Residents using GLDs at admission had long‐standing diabetes (median duration: 12 years [IQR: 6.8–15]), relatively low glycated haemoglobin levels (median: 6.9% [IQR: 6.3–7.8]; 52 mmol/mol [45–62]) with little change around admission, and 43% used more than one GLD class, most commonly metformin (70%) and insulin (36%; basal: 30%; bolus: 16%). Use of glucagon‐like peptide‐1 receptor agonists and sodium‐glucose cotransporter‐2 inhibitors increased over time but remained limited (13% and 24%, respectively, in 2023), despite a high prevalence of cardiorenal disease (84%), and did not differ by cardiorenal disease status. Overall GLD use remained stable around admission, but initiation spiked 3 months before admission (36 initiators/10 000 residents), often following hospitalisation (63%) and primarily involved bolus insulin initiated by hospital physicians.  Conclusions: GLD use for T2D among Danish care home residents is high and shows limited deintensification and potential misalignment with guideline recommendations.
SN  - 1462-8902
SN  - 1463-1326
ER  -