Closed-loop therapy is an effective treatment option for older adults with long-duration type 1 diabetes, and no safety issues were identified. These older adults had higher TIR accompanied by less time below range during closed-loop than during sensor-augmented pump therapy. Of particular clinical importance, closed loop reduced the time spent in hypoglycemic range overnight (Diabetes Care)
Diabetes News
Tag: elderly
When and how to deintensify type 2 diabetes care
Deintensifying type 2 diabetes care can include deprescribing and reducing diabetes-specific assessments that no longer improve quality of life of older adults (BMJ)
Low glycaemic state increases risk of frailty and functional decline in older people with type 2 diabetes mellitus – evidence from a systematic review
Low glycaemia increases risk of frailty and functional decline in older people with type 2 diabetes. Management should minimise incidence of low glycaemia in these patients (Diabetes Research and Clinical Practice)
Association between intensive glycemic control and mortality in elderly diabetic patients in the primary care: A retrospective cohort study
Glycemic target for elderly T2DM patients should be approached cautiously. Over-aggressive treatment may lead to increased mortality among elderly T2DM patients (Primary Care Diabetes)
Effect of diabetes duration on the relationship between glycaemic control and risk of death in older adults with type 2 diabetes
In elderly individuals with T2D, the effect of glycaemic control (measured by HbA1c) on all‐cause mortality depended on the duration of diabetes. Of particular clinical importance, we found that strict glycaemic control was associated with an increased risk of death among individuals with long (>5 years) diabetes duration (Diabetes, Obesity and Metabolism)
Patient Perceptions of Diabetes Guideline Frameworks for Individualizing Glycemic Targets
Many older adults do not place high importance on factors recommended by guidelines to individualize diabetes treatment, especially when deciding to stop use of diabetes medications (JAMA)
Immunological and clinical characteristics of latent autoimmune diabetes in the elderly
Autoantibodies GADA and Znt8A may be useful markers in identifying a subgroup of older patients with a clinical presentation of diabetes which could be characterized as latent autoimmune diabetes in the elderly (Diabetes/Metabolism Research and Reviews)
Preventing misdiagnosis of diabetes in the elderly: age-dependent HbA1c reference intervals derived from two population-based study cohorts
The present study confirmed the previously observed increase of HbA1c with increasing age in non-diabetic individuals. As a consequence age-dependent reference values for HbA1c were derived from two large and well defined reference populations. Implementation of them into daily practice may improve patient care and diagnosis of diabetes and reduce the risk of misdiagnosis and subsequent overtreatment of diabetes in elderly patients (BMC Endocrine Disorders)
Type 2 diabetes mellitus in older people: a brief statement of key principles of modern day management including the assessment of frailty.
We present a framework for the assessment of older adults and guidelines for the management of this population according to their frailty status, with the intention of reducing complications and improving quality of life for these people (Diabetic Medicine)
Diabetes in the Elderly
This review takes a practical approach to the assessment, nursing care, and medical treatment of diabetes in the elderly. It highlights major challenges and suggests solutions to these commonly encountered clinical problems (Diabetes Therapy)
Are we missing hypoglycaemia? Elderly patients with insulin-treated diabetes present to primary care frequently with non-specific symptoms associated with hypoglycaemia
Non-specific symptoms are common in those >65 years. In insulin-treated patients at high hypoglycaemia risk, nausea, falls and unsteadiness should prompt consideration of hypoglycaemia (Primary Care Diabetes)
Liberating A1C goals in older adults may not protect against the risk of hypoglycemia
A1C levels are not associated with hypoglycemia risk in older population with type-2 diabetes on insulin therapy. Higher A1C goals do not protect against hypoglycemia (Diabetes and Its Complications)
Lack of Evidence to Guide Deprescribing of Antihyperglycemics: A Systematic Review
There is limited evidence available regarding deprescribing antihyperglycemic medications. Adequately powered, high-quality studies, particularly in the elderly and with clinically important outcomes, are required to support evidence-based decision-making (Diabetes Therapy)
Meta-Analysis: Association between Hypoglycaemia and Serious Adverse Events in Older Patients
Our meta-analysis raises major concerns about a range of serious adverse events associated with hypoglycaemia. Clinicians should prioritize individualized therapy and closer monitoring strategies to avoid hypoglycaemia in susceptible older patients (Journal of Diabetes and Its Complications)
The effect of frailty should be considered in the management plan of older people with Type 2 diabetes
In frail older people, particularly in those with chronic wasting diseases and significant weight loss, blood glucose levels tend to normalize with increased risk of hypoglycemia. Recurrent hypoglycemia in frail older people with diabetes is a marker of vulnerability and hypoglycemic medication review or even complete withdrawal is appropriate in this group of patients (Future Science)
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