Older adults

A post-hoc analysis of the DAPA-HF trial indicates that dapagliflozin is beneficial in people with heart failure and reduced ejection fraction regardless of frailty, but with the largest gains in the frailest individuals.

Keeping glycated hemoglobin levels within individualized target ranges over time is associated with reduced risk for mortality and cardiovascular disease in older adults with diabetes, suggest results from an observational study.

Researchers find diminished cardiovascular gains and an increased risk for severe hypoglycemia in frail people with type 2 diabetes given intensive glycemic and blood pressure treatment.

SGLT2 inhibitors are associated with lower rates of heart failure hospitalization, all-cause mortality, and hypoglycemia, but higher rates of diabetic ketoacidosis, when compared with DPP-4 inhibitors in older adults with type 2 diabetes, suggests a Canadian study.

Cardiovascular event rates do not differ significantly among people with type 2 diabetes treated with linagliptin or glimepiride regardless of age, but those who receive linagliptin have lower risks for falls and hypoglycemia, CAROLINA trial data show.

Narrower target glucose range than currently recommended may produce the lowest cardiovascular and mortality risk in older Asian people with type 2 diabetes, say the authors of a real-world study.

Older people with and without diabetes experience similar short-term improvements in exercise capacity following cardiac rehabilitation, but those with diabetes fare worse after 1 year, EU-CaRE study results suggest.

Measuring high-sensitivity cardiac troponins I and T can help to refine mortality risk prediction in older adults with diabetes and different levels of comorbidity burden, research shows.

The quality of care among older adults with diabetes declines with increasing comorbidity and is particularly low for those with both osteoarthritis and major depression, population-based study data show.

Primary care physician Jay Shubrook shares his recommendations for diabetes management in a 72-year-old, multi-morbid patient.

Older people starting treatment with sodium-glucose cotransporter 2 inhibitors have a lower risk for hospitalization for heart failure than those starting glucagon-like peptide-1 receptor agonists, research shows.

The addition of empagliflozin reduces nighttime blood pressure in older diabetes patients who have nocturnal hypertension despite medication including angiotensin receptor blockers, show findings from a randomized trial.

The LEADER investigators report that treatment with the glucagon-like peptide-1 receptor agonist liraglutide may be of particular benefit in the oldest patients with type 2 diabetes.

Liu CL et al. BMC Endocr Disord 2018; 18: 45. doi: 10.1186/s12902-018-0273-z

Zhu B et al. Acta Diabetol 2018. doi: 10.1007/s00592-018-1181-4

Saetung S et al. Acta Diabetol 2018. doi: 10.1007/s00592-018-1166-3

The drive to achieve lower HbA1c targets in older patients is not without concern or risk. Our UK Board address concerns highlighted by recent trials and discuss whether current guidelines do enough to mitigate the risks of overtreatment.

Cardiovascular complications, and heart failure in particular, are strongly associated with poor survival in elderly patients with type 2 diabetes, French observational study data show.