More Than Half of Older Diabetics Lack Medicines That Protect Kidneys and Heart

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Diabetes Care

Only 43 percent of older people with diabetes receive medicines that could protect their heart and kidneys, despite the fact that virtually all of them could benefit from those drugs, a new University of Michigan study finds. And even among those with the most to gain from the medicines, the rate of use barely reaches 53 percent.

The classes of prescription medications, called ACE inhibitors and ARBs for short, have been recommended by national diabetes-treatment guidelines for years, because of the strong evidence that they can prevent heart attacks, strokes, kidney failure and other problems that disproportionately threaten older people who have diabetes. The inexpensive drugs are especially recommended for diabetics who already show signs of heart or kidney damage, or who have high blood pressure.

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But the first national study of their actual use in diabetics over age 55 reveals a large gap between what should be and what is.

The study, published in the April issue of the Journal of General Internal Medicine, was conducted by U-M Medical School researcher Allison Rosen, M.D., Sc.D., using data from the federal National Health and Nutrition Examination Survey (NHANES).

"These are drugs that we know save lives and save money, and still we're only using them in less than half of the people who could benefit," says Rosen, an assistant professor of internal medicine at U-M who also holds positions at the U-M School of Public Health and the VA Ann Arbor Healthcare System. "It's especially striking that their rate of use isn't much higher in people most likely to gain

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