Management of diabetes in older adults
Type 2 diabetes prevalence is high in older adults and is expected to rise in the next decades. Diabetes in the population of frail older adults is accompanied by functional disability, several comorbidities, and premature mortality. A comprehensive geriatric assessment, including functional, cognit...
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| Veröffentlicht in: | Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2018-03, Vol.28 (3), p.206-218 |
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| container_title | Nutrition, metabolism, and cardiovascular diseases |
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| creator | Sesti, G. Antonelli Incalzi, R. Bonora, E. Consoli, A. Giaccari, A. Maggi, S. Paolisso, G. Purrello, F. Vendemiale, G. Ferrara, N. |
| description | Type 2 diabetes prevalence is high in older adults and is expected to rise in the next decades. Diabetes in the population of frail older adults is accompanied by functional disability, several comorbidities, and premature mortality. A comprehensive geriatric assessment, including functional, cognitive, mental and social status, is advisable for identifying the glycemic targets and glucose-lowering therapies, focused on patient preferences, needs, and risks. The therapeutic options for older adults with diabetes are like those for the adult population. However, the pharmacological treatments must be carefully prescribed and monitored, taking into consideration the patient cognitive capacities, the potentially life-threatening drug–drug interactions, the cardiovascular risk, and with the main goal of avoiding hypoglycemia. Also, a careful nutritional evaluation with appropriate tools, as well as a balanced and periodically monitored physical activity, contribute to an effective tailored care plan, as needed by older adults with diabetes. This review evaluates the currently available hypoglycemic drugs and the current indications to the Italian diabetology community, specifically with regard to the treatment of adults aged 75 years or older with diabetes, including the unmet needs by the guidelines. |
| doi_str_mv | 10.1016/j.numecd.2017.11.007 |
| format | Article |
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Diabetes in the population of frail older adults is accompanied by functional disability, several comorbidities, and premature mortality. A comprehensive geriatric assessment, including functional, cognitive, mental and social status, is advisable for identifying the glycemic targets and glucose-lowering therapies, focused on patient preferences, needs, and risks. The therapeutic options for older adults with diabetes are like those for the adult population. However, the pharmacological treatments must be carefully prescribed and monitored, taking into consideration the patient cognitive capacities, the potentially life-threatening drug–drug interactions, the cardiovascular risk, and with the main goal of avoiding hypoglycemia. Also, a careful nutritional evaluation with appropriate tools, as well as a balanced and periodically monitored physical activity, contribute to an effective tailored care plan, as needed by older adults with diabetes. This review evaluates the currently available hypoglycemic drugs and the current indications to the Italian diabetology community, specifically with regard to the treatment of adults aged 75 years or older with diabetes, including the unmet needs by the guidelines.</description><identifier>ISSN: 0939-4753</identifier><identifier>EISSN: 1590-3729</identifier><identifier>DOI: 10.1016/j.numecd.2017.11.007</identifier><identifier>PMID: 29337017</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Age Factors ; Aged ; Aged, 80 and over ; Aging - psychology ; Antidiabetic drugs ; Biomarkers - blood ; Blood Glucose - drug effects ; Blood Glucose - metabolism ; Clinical Decision-Making ; Cognition ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - diagnosis ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - psychology ; Drug Interactions ; Female ; Geriatric Assessment ; Humans ; Hypoglycemia ; Hypoglycemia - chemically induced ; Hypoglycemic Agents - adverse effects ; Hypoglycemic Agents - therapeutic use ; Italy ; Male ; Mental Health ; Nutritional Status ; Older adults ; Patient-Centered Care ; Personalized medicine ; Risk Factors ; Treatment Outcome ; Type 2 diabetes</subject><ispartof>Nutrition, metabolism, and cardiovascular diseases, 2018-03, Vol.28 (3), p.206-218</ispartof><rights>2018 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University</rights><rights>Copyright © 2017 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. 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Diabetes in the population of frail older adults is accompanied by functional disability, several comorbidities, and premature mortality. A comprehensive geriatric assessment, including functional, cognitive, mental and social status, is advisable for identifying the glycemic targets and glucose-lowering therapies, focused on patient preferences, needs, and risks. The therapeutic options for older adults with diabetes are like those for the adult population. However, the pharmacological treatments must be carefully prescribed and monitored, taking into consideration the patient cognitive capacities, the potentially life-threatening drug–drug interactions, the cardiovascular risk, and with the main goal of avoiding hypoglycemia. Also, a careful nutritional evaluation with appropriate tools, as well as a balanced and periodically monitored physical activity, contribute to an effective tailored care plan, as needed by older adults with diabetes. This review evaluates the currently available hypoglycemic drugs and the current indications to the Italian diabetology community, specifically with regard to the treatment of adults aged 75 years or older with diabetes, including the unmet needs by the guidelines.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging - psychology</subject><subject>Antidiabetic drugs</subject><subject>Biomarkers - blood</subject><subject>Blood Glucose - drug effects</subject><subject>Blood Glucose - metabolism</subject><subject>Clinical Decision-Making</subject><subject>Cognition</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - diagnosis</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - psychology</subject><subject>Drug Interactions</subject><subject>Female</subject><subject>Geriatric Assessment</subject><subject>Humans</subject><subject>Hypoglycemia</subject><subject>Hypoglycemia - chemically induced</subject><subject>Hypoglycemic Agents - adverse effects</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Italy</subject><subject>Male</subject><subject>Mental Health</subject><subject>Nutritional Status</subject><subject>Older adults</subject><subject>Patient-Centered Care</subject><subject>Personalized medicine</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><subject>Type 2 diabetes</subject><issn>0939-4753</issn><issn>1590-3729</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAQhoMo7rr6D0R6Ei-t-WqTXARZ_IIVL3oOaTKRLP3QpBX893bp6tHTDMPzzjAPQucEFwST6npbdGML1hUUE1EQUmAsDtCSlArnTFB1iJZYMZVzUbIFOklpizETmPFjtKCKTS0RS3T5bDrzDi10Q9b7zAVTwwApC13WNw5iZtzYDOkUHXnTJDjb1xV6u797XT_mm5eHp_XtJrccyyE3HlsqGSOS19wIW6ua1945YpyyQCUXHisvKsu5pYaX0lHKqlpiL2w1zdkKXc17P2L_OUIadBuShaYxHfRj0kRJVUpaSTmhfEZt7FOK4PVHDK2J35pgvTOkt3o2pHeGNCF6MjTFLvYXxroF9xf6VTIBNzMA059fAaJONkBnwYUIdtCuD_9f-AHB0He2</recordid><startdate>201803</startdate><enddate>201803</enddate><creator>Sesti, G.</creator><creator>Antonelli Incalzi, R.</creator><creator>Bonora, E.</creator><creator>Consoli, A.</creator><creator>Giaccari, A.</creator><creator>Maggi, S.</creator><creator>Paolisso, G.</creator><creator>Purrello, F.</creator><creator>Vendemiale, G.</creator><creator>Ferrara, N.</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8200-4942</orcidid><orcidid>https://orcid.org/0000-0002-1618-7688</orcidid><orcidid>https://orcid.org/0000-0002-7462-7792</orcidid></search><sort><creationdate>201803</creationdate><title>Management of diabetes in older adults</title><author>Sesti, G. ; Antonelli Incalzi, R. ; Bonora, E. ; Consoli, A. ; Giaccari, A. ; Maggi, S. ; Paolisso, G. ; Purrello, F. ; Vendemiale, G. ; Ferrara, N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-af0c2833184b4a7cb9b4bfdd1ad9ce2847f09f76c44c2a458d2236b80f7c6f763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging - psychology</topic><topic>Antidiabetic drugs</topic><topic>Biomarkers - blood</topic><topic>Blood Glucose - drug effects</topic><topic>Blood Glucose - metabolism</topic><topic>Clinical Decision-Making</topic><topic>Cognition</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - diagnosis</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - psychology</topic><topic>Drug Interactions</topic><topic>Female</topic><topic>Geriatric Assessment</topic><topic>Humans</topic><topic>Hypoglycemia</topic><topic>Hypoglycemia - chemically induced</topic><topic>Hypoglycemic Agents - adverse effects</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Italy</topic><topic>Male</topic><topic>Mental Health</topic><topic>Nutritional Status</topic><topic>Older adults</topic><topic>Patient-Centered Care</topic><topic>Personalized medicine</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><topic>Type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sesti, G.</creatorcontrib><creatorcontrib>Antonelli Incalzi, R.</creatorcontrib><creatorcontrib>Bonora, E.</creatorcontrib><creatorcontrib>Consoli, A.</creatorcontrib><creatorcontrib>Giaccari, A.</creatorcontrib><creatorcontrib>Maggi, S.</creatorcontrib><creatorcontrib>Paolisso, G.</creatorcontrib><creatorcontrib>Purrello, F.</creatorcontrib><creatorcontrib>Vendemiale, G.</creatorcontrib><creatorcontrib>Ferrara, N.</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Nutrition, metabolism, and cardiovascular diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sesti, G.</au><au>Antonelli Incalzi, R.</au><au>Bonora, E.</au><au>Consoli, A.</au><au>Giaccari, A.</au><au>Maggi, S.</au><au>Paolisso, G.</au><au>Purrello, F.</au><au>Vendemiale, G.</au><au>Ferrara, N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of diabetes in older adults</atitle><jtitle>Nutrition, metabolism, and cardiovascular diseases</jtitle><addtitle>Nutr Metab Cardiovasc Dis</addtitle><date>2018-03</date><risdate>2018</risdate><volume>28</volume><issue>3</issue><spage>206</spage><epage>218</epage><pages>206-218</pages><issn>0939-4753</issn><eissn>1590-3729</eissn><abstract>Type 2 diabetes prevalence is high in older adults and is expected to rise in the next decades. 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| subjects | Age Factors Aged Aged, 80 and over Aging - psychology Antidiabetic drugs Biomarkers - blood Blood Glucose - drug effects Blood Glucose - metabolism Clinical Decision-Making Cognition Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - drug therapy Diabetes Mellitus, Type 2 - psychology Drug Interactions Female Geriatric Assessment Humans Hypoglycemia Hypoglycemia - chemically induced Hypoglycemic Agents - adverse effects Hypoglycemic Agents - therapeutic use Italy Male Mental Health Nutritional Status Older adults Patient-Centered Care Personalized medicine Risk Factors Treatment Outcome Type 2 diabetes |
| title | Management of diabetes in older adults |
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