Telemedicine interventions can improve communication and connection between older patients and their providers , and improve glycemic control .
Summary A systematic review confirmed the efficacy and safety of metformin as first-line therapy of type 2 diabetes in the older adult , but multiple reports highlighted the risk for vitamin B12 deficiency .
R and omized controlled trials showed the efficacy and safety of antihyperglycemic agents in the elderly , including some with longer duration and lesser risk for hypoglycemia .
R and omized clinical trials showed cardiovascular protection with SGLT-2i ( empagliflozin , canagliflozin ) and GLP-1RA ( liraglutide , semaglutide ) .
Purpose of Review The current approach to diabetes in the elderly incorporates components from the comprehensive geriatric approach .
The most up date d guidelines from the American Diabetes Association reflect influence from the consensus made in 2012 with the American Geriatrics Society .
Notably , the framework included the evaluation for geriatric syndromes ( falls and urinary incontinence ) , functional and cognitive abilities .
The goal for this review is to provide an up date d summary of treatment strategies for community-dwelling older adults .
Recent Findings Findings on cardiovascular protection with sodium-glucose co-transporter 2 inhibitors ( SGLT-2i ) and some glucagon-like peptide 1 receptor agonists ( GLP-1RA ) support their use for older patients with diabetes .
Functional medicine concepts can offer additional adjuvant strategies to support the therapeutic interventions and management of diabetes in the elderly .
The most current guidelines recommend addressing for geriatric syndromes , physical and cognitive function in the elderly , in order to individualize targets and therapeutic strategies .
Cardiovascular Events and Geriatric Scale Scores in Elderly (70 Years Old and Above) Type 2 Diabetic Patients at Inclusion in the GERODIAB Cohort
OBJECTIVE To analyze the relationships between cardiovascular complications and geriatric scale scores in French elderly ( ≥70 years of age ) type 2 diabetic patients at inclusion in the GERODIAB cohort . RESEARCH DESIGN AND METHODS GERODIAB is the first French multicenter , prospect i ve , observational survey design ed to analyze the influence of glycemic control on morbidity/mortality in type 2 diabetic patients aged ≥70 years during a 5-year follow-up period . This study analyzed the relationships between classical macroangiopathic complications and  geriatric scale scores  in 987 patients at baseline , using bivariate and multivariate analyses . RESULTS Cardiac ischemia ( 31.2 % ) was significantly associated with impaired activities of daily living ( ADL ) scores ( P < 0.001 ) . Stepwise logistic regression included hypercholesterolemia , ADL , sex , and hypertension successively ( 70.3 % concordance ; P < 0.001 ) . Heart failure ( 10.1 % ) was associated with impaired Mini Mental State Examination ( MMSE ) , instrumental ADL ( IADL ) ( P < 0.05 ) , and ADL scores ( P < 0.001 ) . With the logistic model , waist circumference , age , and HDL cholesterol were significant factors ( 70.7 % concordance ; P < 0.001 ) . Arterial disease of the lower limbs ( 25.6 % ) was associated with impaired IADL and ADL scores ( P < 0.001 ) . Significant factors using the logistic model were duration of diabetes , IADL score , hypertension , and sex ( 62.8 % concordance ; P < 0.001 ) . Cerebral ischemia ( 15.8 % ) was associated with impaired MMSE , Mini Nutritional Assessment , ADL , and IADL scores ( P < 0.01 ) . IADL , sex , hypertension , and ADL were included in the logistic model successively ( 65.6 % concordance ; P < 0.001 ) . CONCLUSIONS In this specific population , impaired geriatric scale scores were found to be associated with classical macrovascular complications , notably using multivariate analyses . This suggests the benefits of thorough screening and management of cognitive and functional decline in elderly type 2 diabetic patients
Telemedicine interventions can improve communication and connection between older patients and their providers , and improve glycemic control .
Summary A systematic review confirmed the efficacy and safety of metformin as first-line therapy of type 2 diabetes in the older adult , but multiple reports highlighted the risk for vitamin B12 deficiency .
R and omized controlled trials showed the efficacy and safety of antihyperglycemic agents in the elderly , including some with longer duration and lesser risk for hypoglycemia .
R and omized clinical trials showed cardiovascular protection with SGLT-2i ( empagliflozin , canagliflozin ) and GLP-1RA ( liraglutide , semaglutide ) .
Purpose of Review The current approach to diabetes in the elderly incorporates components from the comprehensive geriatric approach .
The most up date d guidelines from the American Diabetes Association reflect influence from the consensus made in 2012 with the American Geriatrics Society .
Notably , the framework included the evaluation for geriatric syndromes ( falls and urinary incontinence ) , functional and cognitive abilities .
The goal for this review is to provide an up date d summary of treatment strategies for community-dwelling older adults .
Recent Findings Findings on cardiovascular protection with sodium-glucose co-transporter 2 inhibitors ( SGLT-2i ) and some glucagon-like peptide 1 receptor agonists ( GLP-1RA ) support their use for older patients with diabetes .
Functional medicine concepts can offer additional adjuvant strategies to support the therapeutic interventions and management of diabetes in the elderly .
The most current guidelines recommend addressing for geriatric syndromes , physical and cognitive function in the elderly , in order to individualize targets and therapeutic strategies .