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 .
Diabetes Risk Factors, Diabetes Risk Algorithms, and the Prediction of Future Frailty: The Whitehall II Prospective Cohort Study
Objective To examine whether established diabetes risk factors and diabetes risk algorithms are associated with future frailty . Design Prospect i ve cohort study . Risk algorithms at baseline ( 1997–1999 ) were the Framingham Offspring , Cambridge , and Finnish diabetes risk scores . Setting Civil service departments in London , United Kingdom . Participants There were 2707 participants ( 72 % men ) aged 45 to 69 years at baseline assessment and free of diabetes . Measurements Risk factors ( age , sex , family history of diabetes , body mass index , waist circumference , systolic and diastolic blood pressure , antihypertensive and corticosteroid treatments , history of high blood glucose , smoking status , physical activity , consumption of fruits and vegetables , fasting glucose , HDL-cholesterol , and triglycerides ) were used to construct the risk algorithms . Frailty , assessed during a resurvey in 2007–2009 , was denoted by the presence of 3 or more of the following indicators : self-reported exhaustion , low physical activity , slow walking speed , low grip strength , and weight loss ; “ prefrailty ” was defined as having 2 or fewer of these indicators . Results After a mean follow-up of 10.5 years , 2.8 % of the sample was classified as frail and 37.5 % as prefrail . Increased age , being female , stopping smoking , low physical activity , and not having a daily consumption of fruits and vegetables were each associated with frailty or prefrailty . The Cambridge and Finnish diabetes risk scores were associated with frailty/prefrailty with odds ratios per 1 SD increase ( disadvantage ) in score of 1.18 ( 95 % confidence interval : 1.09–1.27 ) and 1.27 ( 1.17–1.37 ) , respectively . Conclusion Selected diabetes risk factors and risk scores are associated with subsequent frailty . Risk scores may have utility for frailty prediction in clinical practice
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 .