Medications

Older type 2 diabetes patients receiving basal insulin treatment who switch to glargine 300 units/mL experience greater or similar improvements in glycemic control compared with those switching to a first-generation basal insulin, with lower hypoglycemia risk, researchers report.

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.

Diabetologist Amar Puttanna addresses growing concerns about the rise of dementia in diabetes care and highlights where guidelines, research efforts, and management options are needed to tackle this comorbidity.

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.

Valencia WM et al. Curr Diab Rep 2018; 18: 95. doi: 10.1007/s11892-018-1052-y

Research shows an increased mortality risk associated with the use of intensive antidiabetes treatments in older patients with type 2 diabetes.

Insulin titration benefits individuals with type 2 diabetes regardless of age or whether it is self- or physician-managed, according to data presented at the ADA’s 78th Scientific Sessions in Orlando, Florida, USA.

Degludec delivers the same magnitude of protection against hypoglycemia relative to glargine across patient age groups, shows analysis of the SWITCH 2 and DEVOTE trials.

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

Ritzel R et al. Diabetes Care 2018: dc180168. doi: 10.2337/dc18-0168

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

Oriot P et al. Acta Diabetol 2018. doi: 10.1007/s00592-018-1170-7

McCarthy MM, Grey M. Diabetes Care 2018. doi: 10.2337/dc17-2597

An initiative involving “virtual ward” meetings between diabetes specialist nurses, community nurses, and consultants has led to improvements in glycemic control and a reduction in nurse visits among older diabetes patients in North East Essex, study results suggest.

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.

Research suggests that older diabetes patients, particularly those using insulin, often have nonspecific symptoms of hypoglycemia that are overlooked by healthcare providers.

An EASD session on optimizing patient outcomes included research into the effect of guideline adherence, predictors of changes in medication adherence, and overtreatment of older people with diabetes.