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 Units/mL Versus Glargine 100 Units/mL in People With Type 2 Diabetes Using Oral Agents and Basal Insulin: Glucose Control and Hypoglycemia in a 6-Month Randomized Controlled Trial (EDITION 2)
OBJECTIVE To compare the efficacy and safety of new insulin glargine 300 units/mL ( Gla-300 ) with glargine 100 units/mL ( Gla-100 ) in people with type 2 diabetes using basal insulin ( ≥42 units/day ) plus oral antihyperglycemic drugs ( OADs ) . RESEARCH DESIGN AND METHODS EDITION 2 was a multicenter , open-label , two-arm study . Adults receiving basal insulin plus OADs were r and omized  to Gla-300 or Gla-100 once daily for 6 months . The primary end point was change in HbA1c . The main secondary end point was percentage of participants with one or more nocturnal confirmed ( ≤3.9 mmol/L [ ≤70 mg/dL ] ) or severe hypoglycemic events from week 9 to month 6 . RESULTS R and omized participants ( n = 811 ) had a mean ( SD ) HbA1c of 8.24 % ( 0.82 ) and BMI of 34.8 kg/m2 ( 6.4 ) . Glycemic control improved similarly with both basal insulins ; least squares mean ( SD ) reduction from baseline was −0.57 % ( 0.09 ) for Gla-300 and −0.56 % ( 0.09 ) for Gla-100 ( mean difference −0.01 % [ 95 % CI −0.14 to 0.12 ] ) , with 10 % higher dose of Gla-300 . Less nocturnal confirmed ( ≤3.9 mmol/L [ ≤70 mg/dL ] ) or severe hypoglycemia was observed with Gla-300 from week 9 to month 6 ( relative risk 0.77 [ 95 % CI 0.61–0.99 ] ; P = 0.038 ) and during the first 8 weeks . Fewer nocturnal and any time ( 24 h ) hypoglycemic events were reported during the entire 6-month period . Weight gain was lower with Gla-300 than with Gla-100 ( P = 0.015 ) . No between-treatment differences in safety parameters were identified . CONCLUSIONS Gla-300 was as effective as Gla-100 and associated with a lower risk of hypoglycemia during the night and at any time of the day
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 .