Holistic and Personalized Strategies for Managing in Elderly Type 2 Diabetes Patients

Overview

Journal Diabetes Metab J

Specialty Endocrinology

Date 2024 Aug 2

PMID 39091004

Authors

Jae-Seung Yun

Kyuho Kim

Yu-Bae Ahn

Kyungdo Han

Seung-Hyun Ko

Affiliations

Soon will be listed here.

Abstract

Due to increased life expectancy and lifestyle changes, the prevalence of diabetes among the elderly in Korea is continuously rising, as is the associated public health burden. Diabetes management in elderly patients is complicated by age-related physiological changes, sarcopenia characterized by loss of muscle mass and function, comorbidities, and varying levels of functional, cognitive, and mobility abilities that lead to frailty. Moreover, elderly patients with diabetes frequently face multiple chronic conditions that elevate their risk of cardiovascular diseases, cancer, and mortality; they are also prone to complications such as hyperglycemic hyperosmolar state, diabetic ketoacidosis, and severe hypoglycemia. This review examines the characteristics of and management approaches for diabetes in the elderly, and advocates for a comprehensive yet personalized strategy.

Citing Articles

Diabetes Fact Sheets in Korea 2024.

Park S, Ko S, Kim J, Kim K, Moon J, Kim N Diabetes Metab J. 2025; 49(1):24-33.

PMID: 39828976 PMC: 11788544. DOI: 10.4093/dmj.2024.0818.

References

Sinclair A, Morley J, Rodriguez-Manas L, Paolisso G, Bayer T, Zeyfang A . Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in.... J Am Med Dir Assoc. 2012; 13(6):497-502. DOI: 10.1016/j.jamda.2012.04.012. View

Sebastian M, Khan S, Pappachan J, Jeeyavudeen M . Diabetes and cognitive function: An evidence-based current perspective. World J Diabetes. 2023; 14(2):92-109. PMC: 10011899. DOI: 10.4239/wjd.v14.i2.92. View

Deardorff W, Jeon S, Barnes D, Boscardin W, Langa K, Covinsky K . Development and External Validation of Models to Predict Need for Nursing Home Level of Care in Community-Dwelling Older Adults With Dementia. JAMA Intern Med. 2023; 184(1):81-91. PMC: 10696518. DOI: 10.1001/jamainternmed.2023.6548. View

Garber A, Abrahamson M, Barzilay J, Blonde L, Bloomgarden Z, Bush M . CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE COMPREHENSIVE TYPE 2 DIABETES MANAGEMENT ALGORITHM - 2019 EXECUTIVE SUMMARY. Endocr Pract. 2019; 25(1):69-100. DOI: 10.4158/CS-2018-0535. View

Wang Y, Wang J, Gong Q, Wu H, Yang S, He J . Efficacy and safety of glucagon-like peptide-1 receptor agonists in the elderly versus non-elderly patients with type 2 diabetes mellitus: insights from a systematic review. Endocr J. 2024; 71(6):571-582. DOI: 10.1507/endocrj.EJ23-0384. View

Ferriolli E, Pessanha F, Marchesi J . Diabetes and exercise in the elderly. Med Sport Sci. 2014; 60:122-9. DOI: 10.1159/000357342. View

Yun J, Ko S . Avoiding or coping with severe hypoglycemia in patients with type 2 diabetes. Korean J Intern Med. 2015; 30(1):6-16. PMC: 4293565. DOI: 10.3904/kjim.2015.30.1.6. View

Melis R, Marengoni A, Angleman S, Fratiglioni L . Incidence and predictors of multimorbidity in the elderly: a population-based longitudinal study. PLoS One. 2014; 9(7):e103120. PMC: 4109993. DOI: 10.1371/journal.pone.0103120. View

Basu R, Breda E, Oberg A, Powell C, Dalla Man C, Basu A . Mechanisms of the age-associated deterioration in glucose tolerance: contribution of alterations in insulin secretion, action, and clearance. Diabetes. 2003; 52(7):1738-48. DOI: 10.2337/diabetes.52.7.1738. View

10.

Hotamisligil G . Inflammation and metabolic disorders. Nature. 2006; 444(7121):860-7. DOI: 10.1038/nature05485. View

11.

Ida S, Kaneko R, Imataka K, Murata K . Relationship between frailty and mortality, hospitalization, and cardiovascular diseases in diabetes: a systematic review and meta-analysis. Cardiovasc Diabetol. 2019; 18(1):81. PMC: 6582520. DOI: 10.1186/s12933-019-0885-2. View

12.

Frias J, Davies M, Rosenstock J, Perez Manghi F, Lando L, Bergman B . Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes. N Engl J Med. 2021; 385(6):503-515. DOI: 10.1056/NEJMoa2107519. View

13.

. Five insights from the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258):1135-1159. PMC: 7116361. DOI: 10.1016/S0140-6736(20)31404-5. View

14.

Sinclair A, Rodriguez-Manas L . Diabetes and Frailty: Two Converging Conditions?. Can J Diabetes. 2015; 40(1):77-83. DOI: 10.1016/j.jcjd.2015.09.004. View

15.

Bonora B, Avogaro A, Fadini G . Euglycemic Ketoacidosis. Curr Diab Rep. 2020; 20(7):25. DOI: 10.1007/s11892-020-01307-x. View

16.

Custodio Jr J, Roriz-Filho J, Cavalcanti C, Martins A, Salles J . Use of SGLT2 Inhibitors in Older Adults: Scientific Evidence and Practical Aspects. Drugs Aging. 2020; 37(6):399-409. DOI: 10.1007/s40266-020-00757-y. View

17.

Rolland Y, Czerwinski S, Abellan van Kan G, Morley J, Cesari M, Onder G . Sarcopenia: its assessment, etiology, pathogenesis, consequences and future perspectives. J Nutr Health Aging. 2008; 12(7):433-50. PMC: 3988678. DOI: 10.1007/BF02982704. View

18.

Yun J, Ko S . Risk Factors and Adverse Outcomes of Severe Hypoglycemia in Type 2 Diabetes Mellitus. Diabetes Metab J. 2016; 40(6):423-432. PMC: 5167706. DOI: 10.4093/dmj.2016.40.6.423. View

19.

Rigato M, Fadini G, Avogaro A . Safety of sodium-glucose cotransporter 2 inhibitors in elderly patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2023; 25(10):2963-2969. DOI: 10.1111/dom.15193. View

20.

Hopman P, de Bruin S, Forjaz M, Rodriguez-Blazquez C, Tonnara G, Lemmens L . Effectiveness of comprehensive care programs for patients with multiple chronic conditions or frailty: A systematic literature review. Health Policy. 2016; 120(7):818-32. DOI: 10.1016/j.healthpol.2016.04.002. View