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 .
Chronic Low-Calorie Sweetener Use and Risk of Abdominal Obesity among Older Adults: A Cohort Study
Introduction Low-calorie sweetener use for weight control has come under increasing scrutiny as obesity , especially abdominal obesity , remain entrenched despite substantial low-calorie sweetener use . We evaluated whether chronic low-calorie sweetener use is a risk factor for abdominal obesity . Participants and Methods We used 8268 anthropometric measurements and 3096 food diary records with detailed information on low-calorie sweetener consumption in all food products , from 1454 participants ( 741 men , 713 women ) in the Baltimore Longitudinal Study of Aging collected from 1984 to 2012 with median follow-up of 10 years ( range : 0–28 years ) . At baseline , 785 were low-calorie sweetener non-users ( 51.7 % men ) and 669 participants were low-calorie sweetener users ( 50.1 % men ) . Time-varying low-calorie sweetener use was operationalized as the proportion of visits since baseline at which low-calorie sweetener use was reported . We used marginal structural models to determine the association between baseline and time-varying low-calorie sweetener use with longitudinal outcomes —body mass index , waist circumference , obesity and abdominal obesity — with outcome status assessed at the visit following low-calorie sweetener ascertainment to minimize the potential for reverse causality . All models were adjusted for year of visit , age , sex , age by sex interaction , race , current smoking status , dietary intake ( caffeine , fructose , protein , carbohydrate , and fat ) , physical activity , diabetes status , and Dietary Approaches to Stop Hypertension score as confounders . Results With median follow-up of 10 years , low-calorie sweetener users had 0.80 kg/m2 higher body mass index ( 95 % confidence interval [ CI ] , 0.17–1.44 ) , 2.6 cm larger waist circumference ( 95 % CI , 0.71–4.39 ) , 36.7 % higher prevalence ( prevalence ratio = 1.37 ; 95 % CI , 1.10–1.69 ) and 53 % higher incidence ( hazard ratio = 1.53 ; 95 % CI 1.10–2.12 ) of abdominal obesity than low-calorie sweetener non-users . Conclusions Low-calorie sweetener use is independently associated with heavier relative weight , a larger waist , and a higher prevalence and incidence of abdominal obesity suggesting that low-calorie sweetener use may not be an effective means of weight control
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 .