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Older adults and type 2 diabetes

Highlights

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08-03-2020 | Hypoglycemia | Highlight | News

Severe hypoglycemia ‘marker rather than cause’ for longer-term type 2 diabetes mortality risk

Severe hypoglycemia in people with type 2 diabetes is associated with later mortality from a wide range of causes, including those for which there is no obvious underlying mechanism, say researchers.

Doctor_hospital bed

03-24-2020 | Older adults | Highlight | News

Diabetes medication changes at hospital discharge of older adults often not beneficial

Older adults with type 2 diabetes often receive diabetes medication adjustments at hospital discharge that may be of little or no benefit, study results suggest.

Doctor checking blood sugar of senior patient

11-29-2019 | Older adults | Highlight | News

Prediabetes not an immediate mortality concern in older adults

Prediabetes has no effect on the short-term mortality risk of older adults, suggests an analysis of the Atherosclerosis Risk in Communities study.

Carer chatting with elderly patient (symbolic image with models)

10-01-2019 | Older adults | Highlight | News

Type 2 diabetes sex disparities persist into very old age

Known sex differences among younger patients with type 2 diabetes persist among those aged 90 years and older, particularly optimal use of cardiovascular preventive therapies which is significantly less likely among women than men, Spanish research shows.

Elderly diabetic patient (symbolic image with models)

12-03-2018 | Liraglutide (T2DM) | medwireNews | News

Older type 2 diabetes patients may derive greatest liraglutide benefits

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.

06-21-2018 | Sleep disorders | Article

Relationship between sleep disturbance and self-care in adults with type 2 diabetes

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

Elderly diabetic patient (symbolic image with models)

04-19-2018 | Older adults | Highlight | News

Glycemic variability modifies mortality risk in older diabetes patients

The excess mortality risk associated with high or very low glycated hemoglobin values is modified by glycemic variability in diabetes patients aged 70 years or more, shows an analysis of The Health Improvement Network database.

Elderly diabetic patient (symbolic image with models)

02-19-2018 | Older adults | Practical approach | Article

Diabetes in the elderly

This review takes a practical approach to the assessment, nursing care, and medical treatment of diabetes in the elderly, highlighting major challenges and suggesting solutions to common clinical problems.

Pill in hand (symbolic image with model)

02-13-2018 | Older adults | Editorial | Article

Does setting treatment targets risk the overtreatment of type 2 diabetes in older patients?

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.

Editorial Board member Jay Shubrook follows up with treatment individualization specialist David Strain on the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:08).



Learning points include:

  • The rationale for emphasizing quality over quantity of life in certain subsets of the elderly patient population.
  • The importance of incorporating understanding of key comorbidities into treatment planning, including:
    • Left ventricular and/or diastolic dysfunction
    • Chronic kidney disease 
    • Benign prostatic hyperplasia
    • Heart failure
  • Single/multi-agent therapies capable of targeting hypertension and its comorbidities.
  • The importance of early renal function testing in older adults initiated on treatments for hypertension and its comorbidities.
  • Understanding renal impairment risks in vulnerable adults treated with angiotensin-converting-enzyme (ACE) inhibitors in patients.
  • Understanding the relative risk of hyponatremia with generally well-tolerated treatments like as thiazide diuretics.
  • Best practice for avoiding adverse drug events in the acute setting.
  • The challenges associated with treating concomitant heart failure in older adults.

« Video 4: Individualization of diabetes treatment: Considerations for frail, elderly patients with heart failure

Editorial Board member Jay Shubrook talks to treatment individualization specialist David Strain about the treatment challenges presented by older adults, and the implications for tailoring hypertension therapy in this diverse population (11:40).


Learning points include:

  • The ways in which older adults are physiologically distinct from other populations and considerations for appropriate care based on anticipated lifestyle.
  • Expectations for systolic and diastolic blood pressure changes in older adults as well as the impacts they have on cardiovascular health.
  • The importance of specific measures including: pulse pressure, arterial compliance.
  • Risk factors associated with low diastolic blood pressure (<75mmHg) and prospective antihypertensive treatment strategies that may mitigate such risks.

 

« Video 3: When to intervene in patients with diabetes and high blood pressure?



Video 5: Diabetes and blood pressure in the elderly: Which medications to use when; tips for achieving target »