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 .
Lixisenatide Therapy in Older Patients With Type 2 Diabetes Inadequately Controlled on Their Current Antidiabetic Treatment: The GetGoal-O Randomized Trial
OBJECTIVE To evaluate the efficacy and safety of lixisenatide versus placebo on glycemic control in older patients with type 2 diabetes uncontrolled on their current antidiabetic treatment . RESEARCH DESIGN AND METHODS In this phase III , double-blind , r and omized , placebo-controlled , two-arm , parallel-group , multicenter trial , patients aged ≥70 years were r and omized to receive once-daily lixisenatide 20 μg or placebo before breakfast concomitantly with their existing antidiabetic therapy ( including insulin ) for 24 weeks . Patients at risk for malnutrition or with moderate to severe cognitive impairment were excluded . The primary end point was absolute change in HbA1c from baseline to week 24 . Secondary end points included change from baseline to week 24 in 2-h postpr and ial plasma glucose ( PPG ) and body weight . RESULTS A total of 350 patients were r and omized . HbA1c decreased substantially with lixisenatide ( −0.57 % [ 6.2 mmol/mol ] ) compared with placebo ( + 0.06 % [ 0.7 mmol/mol ] ) from baseline to week 24 ( P < 0.0001 ) . Mean reduction in 2-h PPG was significantly greater with lixisenatide ( −5.12 mmol/L ) than with placebo ( −0.07 mmol/L ; P < 0.0001 ) . A greater decrease in body weight was observed with lixisenatide ( −1.47 kg ) versus placebo ( −0.16 kg ; P < 0.0001 ) . The safety profile of lixisenatide in this older population , including rates of nausea and vomiting , was consistent with that observed in other lixisenatide studies . Hypoglycemia was reported in 17.6 % of patients with lixisenatide versus 10.3 % with placebo . CONCLUSIONS In nonfrail older patients uncontrolled on their current antidiabetic treatment , lixisenatide was superior to placebo in HbA1c reduction and in targeting postpr and ial hyperglycemia , with no unexpected safety findings
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 .