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 .
Diabetes and risk of frailty and its potential mechanisms: a prospective cohort study of older adults.
BACKGROUND There is emerging evidence of the role of diabetes as a risk factor for frailty . However , the mechanisms of this association are uncertain . METHODS Prospect i ve cohort study of 1750 noninstitutionalized individuals aged 60 years or older recruited in 2008 - 2010 . At baseline , information was obtained on health behaviors , morbidity , cardiometabolic biomarkers , and antidiabetic treatments .  Individuals were considered diabetic if they reported a physician diagnosis or had fasting serum glucose of 126 mg/dL or higher . Study participants were followed through 2012 to assess incident frailty , defined as at least 3 of the 5 Fried criteria . RESULTS At baseline , the cohort included 346 individuals with diabetes and 1404 without diabetes . Over a mean 3.5-year follow-up , 115 cases of incident frailty were ascertained . After adjustment for age , sex , and education , participants with diabetes showed an increased risk of frailty ( odds ratio [ OR ] 2.18 , 95 % confidence interval [ CI ] 1.42 - 3.37 ) . Additional adjustment for health behaviors and abdominal obesity yielded a 29.7 % reduction in the OR ( OR 1.83 , 95 % CI 1.16 - 2.90 ) . Subsequent adjustment for morbidity produced an additional 8.4 % reduction ( OR 1.76 , 95 % CI 1.10 - 2.82 ) , and for cardiometabolic biomarkers , a further 44 % reduction ( OR 1.32 , 95 % CI 0.70 - 2.49 ) . In particular , adjustment for HbA1c , lipoproteins , and triglycerides accounted for the greatest reductions . Finally , additional adjustment for oral antidiabetic medication reduced the OR to 1.01 ( 95 % CI 0.46 - 2.20 ) , whereas adjustment for nutritional therapy increased the OR to 1.64 ( 95 % CI 0.77 - 3.49 ) . CONCLUSIONS Diabetes mellitus is associated with higher risk of frailty ; this association is partly explained by unhealthy behaviors and obesity and , to a greater extent , by poor glucose control and altered serum lipid profile among diabetic individuals . Conversely , diabetes nutritional therapy reduces the risk of frailty
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 .