2.1 In patients aged 65 years and older without known diabetes, we recommend fasting plasma glucose and/or HbA1c screening to diagnose diabetes or prediabetes.+ 1.0 Role of the Endocrinologist and Diabetes Care Specialist Guideline recommendations also address common co-morbidities such as renal impairment, which affects the pharmacokinetics and pharmacodynamics of specific agents, and concomitant heart disease.The guideline presents evidence for the various effects of diabetes in the older patients and the relevant therapies for glycemic control, hyperlipidemia and hypertension.Such complications can lead to an increased risk of poor medication adherence, hypoglycemia (from certain medications), falls, and loss of independence in daily living activities. The problems that older individuals with diabetes face, in contrast to younger people with the disease, include sarcopenia, frailty and cognitive dysfunction.
Given the heterogeneity of the health status of older people with diabetes, the guideline emphasizes shared decision-making and provides a framework to assist health care providers to individualize treatment goals. Clinicians should perform regular screening for prediabetes and diabetes in the older population and implement interventions as indicated in this guideline. The prevalence of type 2 diabetes increases as individuals age and exaggerates the incidence of both microvascular and macrovascular complications. Prediabetes is highly prevalent in older people, however, interventions to delay progression from prediabetes to diabetes are especially effective in this age group. Executive Summary Translations | Endocrine Society. Q&A: Derek LeRoith, MD, PhD, Discusses Society Guideline on Treating Older Diabetes Patients | Endocrine News. App and point of care tools | Endocrine Society. Guidelines Pocket Card | Guideline Central. Clinician Education (Free CME) | Endocrine Society. Educational Slide Deck | Endocrine Society. Clinician Education Presentation | ENDO 2019. Lipid-lowering agents in older individuals: A systematic Review and Meta-analysis of Randomized Clinical Trials. Anti-hypertensive agents in older adults: A systematic Review and Meta-analysis of Randomized Clinical Trials. Emphasizes shared-decision making and lesser targets/goals depending on health condition. Provides recommendations for older patients with diabetes and macro and microvascular co-morbidities. Provides recommendations for the screening, diagnosis, and treatment of diabetes in older adults. The 2019 guideline on treatment of diabetes in older adults: Doctors in training step 2 endocrine 8 full#
Full Guideline: Treatment of Diabetes in Older Adultsĭerek LeRoith, Geert Jan Biessels, Susan S.
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