Even though clinical guidelines encourage some older adults to de-intensify diabetes treatment if they’ve had the condition longer, some patients aren’t willing to take less medication, a study finds.

Older adults with type 2 diabetes who were willing to take less drugs tended to be younger and have diabetes for a shorter duration of time, the data showed. Clinical guidelines recommend lowering treatment in older adults who have had the disease longer, have poor health status, have limited life expectancy or have an HbA1c level that’s less than 7%.

The report was published in the Journal of the American Geriatrics Society on Tuesday. Data came from a survey of 1,337 older adults who had diabetes. All of the participants were between 65 and 100 years old and were on medications to lower their glucose. The data originated from the Kaiser Permanente Northern California Diabetes Registry. The study didn’t say if people on the registry were eligible to de-intensify treatment, but it’s made up of older people who generally are instructed to do so.

Participants had to describe if they were willing, neutral or unwilling to take less medication for their diabetes. Willingness to lower diabetes treatment was subject to several clinical factors including the American Diabetes Association (ADA) health status categories used for customizing glycemic targets.

Of the participants, 51.2% were willing to lower their medications while 27.3% were neutral on the concept and 21.5% reported being not willing to reduce drugs. Those who were willing to taper down on diabetes drugs were more apt to be in the 65-to-74-year-old category compared to those 85 and up. And of the participants, 61% willing to reduce meds had diabetes for four years or less compared to those who had it for 15 years or more.

People who were taking one to two medications (for any ailment) were more willing to take less medication(s) compared with those on 10 or more medications. Similar proportions of willingness to take less medications were seen regardless of ADA health status and HbA1c levels. 

Nearly 71% of those surveyed said they trusted their clinicians, and nearly 63% said their healthcare professionals always explained things so they could understand it. Interestingly, 57.3% of those surveyed said clinicians always involved them in making decisions about their care.