Older Adults

The natural history of diabetes in older adults differs from that in younger patients, due in part to shorter life expectancy, increased comorbidity and a greater risk of treatment-related complications.1

  • 50-80% of adults >65 years of age have diabetes or prediabetes.2
  • 61% of all expenditures attributed to diabetes are incurred by patients>65 years. 3
  • Older adults with diabetes havehigher complication rates than younger cohorts.3
  • One-third of all individuals with diabetes are >65 years.4

 

Diabetes management strategies for high-functioning older people with a long life expectancy are similar to those used in younger patients.1Life expectancy is an important factor in treatment decisions for older patients near the end of life. As morbidity and functional impairment increase, the anticipated benefit of glycemic control declines.2

Algorithm to Simplify Insulin Regimen in Older Adults with T2DM.5

Resources

American Diabetes Association. 12. Older Adults: Standards of Medical Care in Diabetes—2019. Diabetes Care. 2019;42(Supplement 1):S139-S147.

References

  1. Strain WD, Hope SV, Green A, Kar P, Valabhji J, Sinclair AJ. Type 2 diabetes mellitus in older people: a brief statement of key principles of modern day management including the assessment of frailty. A national collaborative stakeholder initiative. Diabetic Medicine. 2018;35(7):838-845. doi:10.1111/dme.13644
  2. Halter JB, Musi N, Horne FM, et al. Diabetes and Cardiovascular Disease in Older Adults: Current Status and Future Directions. Diabetes. 2014;63(8):2578-2589. doi:10.2337/db14-0020
  3. Leung E, Wongrakpanich S, Munshi MN. Diabetes Management in the Elderly. Diabetes Spectrum. 2018;31(3):245-253. doi:10.2337/ds18-0033
  4. Schernthaner G, Schernthaner-Reiter MH. Diabetes in the older patient: heterogeneity requires individualisation of therapeutic strategies. Diabetologia. 2018;61(7):1503-1516. doi:10.1007/s00125-018-4547-9
  5. American Diabetes Association. 12. Older Adults: Standards of Medical Care in Diabetes—2019. Diabetes Care. 2019;42(Supplement 1):S139-S147. doi:10.2337/dc19-S012