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 .
Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults
BACKGROUND Obesity causes frailty in older adults ; however , weight loss might accelerate age‐related loss of muscle and bone mass and result ant sarcopenia and osteopenia . METHODS In this clinical trial involving 160 obese older adults , we evaluated the effectiveness of several exercise modes in reversing frailty and preventing reduction in muscle and bone mass induced by weight loss . Participants were r and omly assigned to a weight‐management program plus one of three exercise programs — aerobic training , resistance training , or combined aerobic and resistance training — or to a control group ( no weight‐management or exercise program ) . The primary outcome was the change in Physical Performance Test score from baseline to 6 months ( scores range from 0 to 36 points ; higher scores indicate better performance ) . Secondary outcomes included changes in other frailty measures , body composition , bone mineral density , and physical functions . RESULTS A total of 141 participants completed the study .  The Physical Performance Test score increased more in the combination group than in the aerobic and resistance groups ( 27.9 to 33.4 points [ 21 % increase ] vs. 29.3 to 33.2 points [ 14 % increase ] and 28.8 to 32.7 points [ 14 % increase ] , respectively ; P=0.01 and P=0.02 after Bonferroni correction ) ; the scores increased more in all exercise groups than in the control group ( P<0.001 for between‐group comparisons ) . Peak oxygen consumption ( milliliters per kilogram of body weight per minute ) increased more in the combination and aerobic groups ( 17.2 to 20.3 [ 17 % increase ] and 17.6 to 20.9 [ 18 % increase ] , respectively ) than in the resistance group ( 17.0 to 18.3 [ 8 % increase ] ) ( P<0.001 for both comparisons ) . Strength increased more in the combination and resistance groups ( 272 to 320 kg [ 18 % increase ] and 288 to 337 kg [ 19 % increase ] , respectively ) than in the aerobic group ( 265 to 270 kg [ 4 % increase ] ) ( P<0.001 for both comparisons ) . Body weight decreased by 9 % in all exercise groups but did not change significantly in the control group . Lean mass decreased less in the combination and resistance groups than in the aerobic group ( 56.5 to 54.8 kg [ 3 % decrease ] and 58.1 to 57.1 kg [ 2 % decrease ] , respectively , vs. 55.0 to 52.3 kg [ 5 % decrease ] ) , as did bone mineral density at the total hip ( grams per square centimeter ; 1.010 to 0.996 [ 1 % decrease ] and 1.047 to 1.041 [ 0.5 % decrease ] , respectively , vs. 1.018 to 0.991 [ 3 % decrease ] ) ( P<0.05 for all comparisons ) . Exercise‐related adverse events included musculoskeletal injuries . CONCLUSIONS Of the methods tested , weight loss plus combined aerobic and resistance exercise was the most effective in improving functional status of obese older adults . ( Funded by the National Institutes of Health ; LITOE Clinical Trials.gov number , NCT01065636 .
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 .