Treatment of Diabetes in Older Adults

Publication Date: March 23, 2019

Key Points

Key Points

Prediabetes is highly prevalent in older people, however, interventions to delay progression from prediabetes to diabetes are especially effective in this age group.

The prevalence of type 2 diabetes increases as individuals age and exaggerates the incidence of both microvascular and macrovascular complications.

Clinicians should perform regular screening for prediabetes and diabetes in the older population and implement interventions as indicated in this guideline.

Given the heterogeneity of the health status of older people with diabetes, the guideline emphasizes shared decision-making and provides a framework to assist health care providers to individualize treatment goals.

The problems that older individuals with diabetes face, in contrast to younger people with the disease, include sarcopenia, frailty and cognitive dysfunction. Such complications can lead to an increased risk of poor medication adherence, hypoglycemia (from certain medications), falls, and loss of independence in daily living activities.

The guideline presents evidence for the various effects of diabetes in the older patients and the relevant therapies for glycemic control, hyperlipidemia and hypertension.

Guideline recommendations also address common co-morbidities such as renal impairment, which affects the pharmacokinetics and pharmacodynamics of specific agents, and concomitant heart disease.

Diagnosis and Prevention

...osis and Preventio...

In patients aged 65 years and olde...


...s aged 65 years and older without known diabetes...


...65 years and older who have prediabete...


...ADA Criteria for PrediabetesaHaving trou...


Assessment

Assessm...

...alth Assessment of Older Patients With...

...d 65 and older with diabetes, we advise assessing...

...ents aged 65 years and older with diabetes, E...

...aged 65 years and older with diabetes and a dia...

...nical Care of Older PeopleHaving t...

...ptual Framework for Considering Overall Hea...

.... Tools to Detect Frailty Having troub...

...y Employed Measures to Screen for Physical Impa...


Treatment

...eatment...

...Endocrinologist and Diabetes Care...

...ts aged 65 years and older with newly diagnosed...

...ged 65 years and older with diabetes,...


...nt of Hyperglycemia

...Glycemic Targets and Goals

...ients aged 65 years and older with diabete...

...sing Glycemia...

...patients aged 65 years and older with diabe...

...festyle Interventions

...nts aged 65 years and older with diabet...

...ts aged 65 years and older with diabetes,...

...ients aged 65 years and older with diabetes...

...ged 65 years and older with diabetes who can...

...Therapy for Hyperglycemi...

...ents aged 65 years and older with di...

...65 years and older with diabetes who have not...


...eating Complications of Diabe...

Hypertensio...

...aged 65 to 85 years with diabetes,...

...nts aged 65 years and older with diabetes and hyp...

...rlipidemia...

...patients aged 65 years and older with diabet...

...nts aged 65 years and older with diabete...

...patients aged 65 years and older with diabetes, ES...

...65 years and older with diabetes...

Congestive Heart Fa...

...patients aged 65 years and older who have diabete...

...aged 65 years and older who have diabetes...

...rosclerosis

...aged 65 years and older with diabete...

...omplications...

...s aged 65 years and older with dia...

...ropathy, Falls, and Lower Extrem...

...d 65 years and older with diabetes and advance...

...ed 65 years and older with diabetes and pe...

...ients aged 65 years and older with diabetes and p...

...onic Kidney Disease

...n patients aged 65 years and older with diabe...

...s aged 65 years and older with diabetes w...

...nts aged 65 years and older with diabetes an...

...cations Used to Treat Hyperglycemia and Spe...

...ement of Diabetes Away From Home – in Hosp...

...ts aged 65 years and over with diabet...

...patients aged 65 years and older wit...

...ged 65 years and older without diagnosed diabe...