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 .
Effects of empagliflozin on blood pressure and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes
Aims To determine the effects of empagliflozin on blood pressure ( BP ) and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes mellitus ( T2DM ) . Methods We conducted a post hoc analysis of data from a phase III trial in patients with T2DM and hypertension receiving 12 weeks ' empagliflozin and four phase III trials in patients with T2DM receiving 24 weeks ' empagliflozin ( cohort 1 , n = 823 ; cohort 2 , n = 2477 ) . BP was measured using 24‐h BP monitoring ( cohort 1 ) or seated office measurements ( cohort 2 ) . Results Empagliflozin  reduced systolic BP ( SBP ) and diastolic BP in both cohorts ( p < 0.001 vs placebo ) , without increasing heart rate  . Empagliflozin  reduced pulse pressure ( PP ; adjusted mean difference vs placebo cohort 1 : −2.3 mmHg ; cohort 2 : −2.3 mmHg ) , mean arterial pressure ( MAP ; cohort 1 , −2.3 mmHg ; cohort 2 , −2.1 mmHg ) and double product ( cohort 1 , −385 mmHg × bpm ; cohort 2 , −369 mmHg × bpm ) all p < 0.001 vs placebo . There was a trend towards a reduction in the ambulatory arterial stiffness index ( AASI )  with empagliflozin in cohort 1 ( p = 0.059 vs placebo ) . AASI was not measured in cohort 2 . Subgroup analyses showed that there were greater reductions in PP with increasing baseline SBP in cohort 1 ( p = 0.092 ) . In cohort 2 , greater reductions in MAP were achieved in patients with higher baseline SBP ( p = 0.027 ) and greater reductions in PP were observed in older patients ( p = 0.011 ) . Conclusions Empagliflozin  reduced BP and had favourable effects on markers of arterial stiffness and vascular resistance
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 .