Impact of frailty metabolic phenotypes on the management of older people with type 2 diabetes mellitus

Aims To provide a pathophysiological basis for distinguishing metabolic variants of the frailty phenotype in older adults with type 2 diabetes. Methods We have made an in‐depth review of the possible mechanisms in diabetes, ageing and frailty that will alter allow us to describe phenotypic changes which might assist in predicting responses to particular glucose‐lowering therapy. Results Our review has enable us to describe with some confidence a sarcopenic obese phenotype and an anorexic malnourished phenotype. Conclusions By identifying these two phenotypes we can predict which would be most responsive to certain classes of therapy and where therapies may be ill‐advised. This represents the first novel approach in this area. Further work is being planned to develop this hypothesis. Geriatr Gerontol Int 2021; 21: 614–622.