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 .
Efficacy and safety of dapagliflozin monotherapy in people with Type 2 diabetes: a randomized double-blind placebo-controlled 102-week trial.
AIMS To assess initial pharmacotherapy of Type 2 diabetes with the sodium-glucose cotransporter-2 inhibitor dapagliflozin . METHODS This double-blind , placebo-controlled trial , r and omly allocated people with Type 2 diabetes aged 18 - 77 years and inadequate glycaemic control on diet and exercise [ HbA1c 53 - 86 mmol/mol ( 7.0 - 10.0 % ) ] to receive placebo ( n = 75 ) or dapagliflozin monotherapy 2.5 mg ( n = 65 ) , 5 mg ( n = 64 ) or 10 mg ( n = 70 ) once daily in the morning . After 24 weeks , low-dose double-blind metformin 500 mg/day was added to the placebo group regimen ( placebo+low-dose metformin group ) . Changes in HbA1c level , fasting plasma glucose and body weight , as well as adverse events , were assessed over 102 weeks . RESULTS Of the 274 participants r and omized , 167 completed the study ( 60.9 % ) . At 102 weeks , significant differences vs placebo+low-dose metformin with dapagliflozin 5 and 10 mg were observed for HbA1c ( -5.8 mmol/mol [ -0.53 % ] , P = 0.018 ; and -4.8 mmol/mol [ -0.44 % ] , P = 0.048 ) , respectively ) ; and for FPG ( -0.69 mmol/L , P = 0.044 ; and -1.12 mmol/l , P = 0.001 , respectively ) . For body weight , the difference between the dapagliflozin 10-mg group and the placebo+low-dose metformin group was significant ( -2.60 kg ; P = 0.016 ) . Hypoglycaemic events were uncommon , with rates of 5.3 % for placebo+low-dose metformin group and 0 - 4.6 % for the dapagliflozin groups . Genital infections and urinary tract infections were more common in the dapagliflozin groups than in the placebo+low-dose metformin group . CONCLUSIONS Dapagliflozin as monotherapy in treatment-naïve people with early Type 2 diabetes improved glycaemic control and reduced weight without increasing hypoglycaemia over 102 weeks . Dapagliflozin may provide an alternative initial pharmacotherapy in such people
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 .