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 .
A Dietary Supplement Containing Cinnamon, Chromium and Carnosine Decreases Fasting Plasma Glucose and Increases Lean Mass in Overweight or Obese Pre-Diabetic Subjects: A Randomized, Placebo-Controlled Trial
Background Preventing or slowing the progression of prediabetes to diabetes is a major therapeutic issue . Objectives Our aim was to evaluate the effects of 4-month treatment with a dietary supplement containing cinnamon , chromium and carnosine in moderately obese or overweight pre-diabetic subjects , the primary outcome being change in fasting plasma glucose ( FPG ) level . Other parameters of plasma glucose homeostasis , lipid profile , adiposity and inflammatory markers were also assessed . Methods In a r and omized , double-blind , placebo-controlled study , 62 subjects with a FPG level ranging from 5.55 to 7 mmol/L and a body mass index ≥25 kg/m2 , unwilling to change their dietary and physical activity habits , were allocated to receive a 4-month treatment with either 1.2 g/day of the dietary supplement or placebo . Patients were followed up until 6 months post-r and omization . Results Four-month treatment with the dietary supplement  decreased FPG compared to placebo ( -0.24±0.50 vs + 0.12±0.59 mmol/L , respectively , p = 0.02 ) , without detectable significant changes in HbA1c . Insulin sensitivity markers , plasma insulin , plasma lipids and inflammatory markers did not differ between the treatment groups . Although there were no significant differences in changes in body weight and energy or macronutrient intakes between the two groups , fat-free mass ( % ) increased with the dietary supplement compared to placebo ( p = 0.02 ) . Subjects with a higher FPG level and a milder inflammatory state at baseline benefited most from the dietary supplement . Conclusions Four-month treatment with a dietary supplement containing cinnamon , chromium and carnosine decreased FPG and increased fat-free mass in overweight or obese pre-diabetic subjects . These beneficial effects might open up new avenues in the prevention of diabetes . Trial Registration Clinical Trials.gov
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 .