Alvarenga de Piauhy 2021 Prize of the Royal Academy of Medicine of Belgium awarded to Dr Antoine Christiaens

Dr Antoine Christiaens (LDRI TFAR/CLIP) received the Alvarenga de Piauhy Prize 2021 from the Royal Academy of Medicine of Belgium.

Implications of health and metabolic heterogeneities for glycaemic management in older patients with type 2 diabetes

Type 2 diabetes (T2D) is one of the most prevalent chronic condition in older people, a heterogeneous population in terms of health status. Therefore, risks and benefits of glycaemic control by glucose-lowering treatment (GLT) may differ considerably between patients and must be wisely balanced to avoid harmful consequences, i.e. hypoglycaemic events. The objectives of this research project were (i) to review the recommendations of recent clinical practice guidelines (CPGs) for individualised glycaemic management in older patients with T2D, (ii) to evaluate the application of these recommendations in clinical practice, and (iii) to describe the metabolic heterogeneity in these patients. In total, six studies were conducted. This project found that (i) the recommendations are of low level of evidence and differ between CPGs; (ii) individualisation of GLT is poorly achieved, overtreatment of T2D is common in different samples of the older population, and is associated with increased one-year mortality; (iii) there is significant metabolic heterogeneity among older patients with T2D, and these can be classified into five distinct groups according to their metabolic characteristics. The results provide strong encouragement to follow more assiduously recommendations for individualising the glycaemic management in older patients with T2D, and to continue research in this field to provide high-level evidence recommendations.