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 .
New insulin glargine 300 U/ml compared with glargine 100 U/ml in insulin-naïve people with type 2 diabetes on oral glucose-lowering drugs: a randomized controlled trial (EDITION 3)
Aims To compare the efficacy and safety of new insulin glargine 300 U/ml ( Gla-300 ) with that of glargine 100 U/ml ( Gla-100 ) in insulin-naïve people with type 2 diabetes using oral glucose-lowering drugs . Methods The EDITION 3 study was a multicentre , open-label , parallel-group study . Participants were r and omized to Gla-300 or Gla-100 once daily for 6 months , discontinuing sulphonylureas and glinides , with a dose titration aim ed at achieving pre-breakfast plasma glucose concentrations of 4.4–5.6 mmol/l ( 80–100 mg/dl ) . The primary endpoint was change in glycated haemoglobin ( HbA1c ) from baseline to month 6 . The main secondary endpoint was percentage of participants with ≥1 nocturnal confirmed [ ≤3.9 mmol/l ( ≤70 mg/dl ) ] or severe hypoglycaemia from week 9 to month 6 . Other measures of glycaemia and hypoglycaemia , weight change and insulin dose were assessed . Results R and omized participants ( n = 878 ) had a mean ( st and ard deviation ) age of 57.7 ( 10.1 ) years , diabetes duration 9.8 ( 6.4 ) years , body mass index 33.0 ( 6.7 ) kg/m2 and HbA1c 8.54 ( 1.06 ) % [ 69.8 ( 11.6 ) mmol/mol ] . HbA1c levels decreased by equivalent amounts with the two treatments ; the least squares mean difference in change from baseline was 0.04 [ 95 % confidence interval ( CI ) −0.09 to 0.17 ] % or 0.4 ( −1.0 to 1.9 ) mmol/mol . Numerically fewer participants reported ≥1 nocturnal confirmed ( ≤3.9 mmol/l ) or severe hypoglycaemia from week 9 to month 6 [ relative risk ( RR ) 0.89 ( 95 % CI 0.66 to 1.20 ) ] with Gla-300 versus Gla-100 ; a significantly lower risk of hypoglycaemia with this definition was found over the 6-month treatment period [ RR 0.76 ( 95 % CI 0.59 to 0.99 ) ] . No between-treatment differences in adverse events were identified . Conclusions Gla-300 is as effective as Gla-100 in reducing HbA1c in insulin-naïve people with type 2 diabetes , with lower hypoglycaemia risk
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 .