The Endocrine Society has published new practice guidelines for the treatment of diabetes in older adults. The new guidelines aim to provide guidance to practising health care providers that will benefit patients aged 65 years and older with type 1 or 2 diabetes, with particular attention on avoiding unnecessary and/or harmful adverse effects.
Recommendations are made in areas including screening for diabetes and pre-diabetes and diabetes prevention, assessment of older adults with diabetes, treatment of hyperglycaemia and treating co-morbidities and complications of diabetes.
Amongst the recommendations are:
- Patients aged 65 years and older without known diabetes should be screened for diabetes and pre-diabetes every two years using fasting plasma glucose and/or HbA1c.
- Metformin is the first-line treatment of choice in combination with lifestyle management.
- Periodic cognitive screening is recommended to identify undiagnosed cognitive impairment.
- In patients with diabetes and a diagnosis of cognitive impairment, glycaemic targets should be tailored, and medication regimens should be simplified to improve compliance and prevent treatment-related complications.
The guidelines are published in the Journal of Clinical Endocrinology & Metabolism.