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Background Intensive therapy is often required to reach glycated haemoglobin targets in people with Type 2 Diabetes (T2D), however, aggressive treatment in people &amp;gt;80 years, frail individuals and people with dementia may be harmful. We aimed to determine whether these factors predict the intensity of anti-hyperglycaemic therapies prescribed for older hospitalised patients with T2D. Methods A cohort study was completed using discharge prescribing data from Melbourne’s Eastern Health hospital network. We identified 3,067 patients, aged 65-99 years, with T2D, at least one diabetes related complication and an index discharge between 2012 and 2016. Multinomial Logistic Regression was used to estimate adjusted Odds Ratios (ORs) with 95% confidence intervals (CI) for being prescribed insulin-only (IO), non-insulin anti-hyperglycaemics only (NIO) or a combination of those two (CT) compared to no anti-hyperglycaemics (NA). Results At discharge, 23% of patients were prescribed NA, 19% IO, 39% NIO and 20% CT. People aged &amp;gt;80 were less likely than those aged 65-80 to be discharged with IO (OR = 0.53; 95%CI [0.42-0.68]) or CT (OR = 0.37; 95%CI [0.30-0.47]), compared to NA. Frailty was negatively associated with being prescribed IO (OR 0.64; 95%CI [0.43-0.94]) or NIO (OR 0.64; 95%CI [0.46-0.89], compared to NA. People with dementia were less likely to be discharged with CT (OR 0.56; 95%CI [0.34-0.92]) compared to NA. Conclusions Prescribers recognise advancing age, frailty and dementia as factors which necessitate less intensive T2D treatment in hospitalised older adults. Key messages Frailty, independent of chronological age, is associated with receiving less intensive T2D therapy in older hospitalised patients.

883Discharge Prescribing in Older Adults with Type 2 Diabetes Hospitalised for Diabetes-related Complications