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Critical gaps exist in treatment options for older diabetics
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According to a consensus report on diabetes in older adults by the American Diabetes Association and the American Geriatrics Society, adults aged at least 65 years are more likely to have diabetes than any other age group. However, the necessary evidence-based treatment options for this population is not available to clinicians, they said.
“With our nation’s aging population, it becomes increasingly important for us to understand how diabetes is impacting older adults,” Geralyn Spollett, MSN, ANP-CS, CDE, president of health care and education at the ADA, said in a press release. “We know a great deal about how to help middle-aged adults prevent and manage diabetes, but little about those in their later years, who are far more likely to be diagnosed and to suffer from the serious and life-threatening complications associated with this disease.”
According to the report published in Diabetes Care, the ADA developed a consensus panel to address the following questions:
- What is the epidemiology and pathogenesis of diabetes in older adults?
- What is the evidence for preventing and treating diabetes and its common comorbidities in older adults?
- What current guidelines exist for treating diabetes in older adults?
- What issues need to be considered in individualizing treatment recommendations for older adults?
- What are consensus recommendations for treating older adults with or at risk for diabetes?
- How can gaps in the evidence best be filled?
“One important issue is that older people are a very heterogeneous population, which means that recommendations cannot simply be based on age. One 75-year-old may have newly diagnosed diabetes but otherwise be quite healthy and lead a very active life, while another may have multiple diseases, dementia and longstanding diabetes with complications,” consensus panel member Jeffrey B. Halter, MD, director of the Geriatrics Center at the University of Michigan, and past-president of the American Geriatrics Society, said in a press release. “It’s critical to consider overall physical and cognitive function, quality of life, and patient preferences when developing a treatment plan with an older patient.”
The panel members developed an array of recommendations for clinicians treating older adults with or at risk for diabetes (ie, considering goals for glycemia, blood pressure and dyslipidemia). Furthermore, the panel suggest future research establish “real-world” settings and populations to understand the complexity of older adults and call for a broader approach to conducting trials.
Disclosure: See the study for a full list of disclosures.
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