Key result
Management of diabetes in the elderly requires an individualized approach, with HbA1c targets adjusted based on life expectancy, frailty, and the need to avoid hypoglycemia.
Diabetes management in the elderly requires an individualized approach, tailoring HbA1c targets based on life expectancy and frailty while prioritizing the avoidance of hypoglycemia.
Supports individualized HbA1c targets in elderly diabetes to minimize hypoglycemia; leaves open optimal thresholds by frailty for prospective trials.
PURPOSE OF REVIEW: Description of management of diabetes in elderly. RECENT FINDINGS: Population of older adults is growing and so is the prevalence of diabetes in elderly individuals. Older adults are a heterogeneous group of individuals with varying physical capabilities, cognitive functioning and co-morbidities and life expectancies. Also, older adults with diabetes are at increased risk for some geriatric conditions. Thus, clinicians taking care of elderly with diabetes must take this into consideration and prioritize treatment accordingly. SUMMARY: Goals of diabetes care in elderly and younger adults are alike, though managing diabetes in elderly requires individualized approach. Fit elderly with life expectancy over 10 years should have HbA1c target similar to younger adults, whereas in frail elderly with multiple co-morbidities, the goal should somewhat be higher. Pharmacological treatment options are similar to younger adults and avoidance of hypoglycemia is an important consideration in choosing therapeutic agents in elderly. Evaluation and treatment of microvascular and macrovascular complications of diabetes in elderly must also be individualized.
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Chiniwala et al. (2011) conducted a review in Diabetes mellitus in the elderly. Management of diabetes was evaluated. Management of diabetes in the elderly requires an individualized approach, with HbA1c targets adjusted based on life expectancy, frailty, and the need to avoid hypoglycemia.
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