Endocrine Societies Set Up New Guidelines To Address Diabetes Issues In Older Adult

The new guidelines from the Endocrine Society addresses multiple complex problems involved in managing diabetes in older adults.

The document, Treatment of Diabetes In Older Adults: An Endocrine Society Clinical Practice Guidelines, was officially launched at the 2019 Endocrine Society Annual Meeting and was published in the Journal of Clinical Endocrinology and Metabolism alongside with other online resources.

During a press briefing, the committee chairman Derek LeRoith, MD, PhD, of the Kahn School of Medicine at Mount Sinai New York City, said, "For the past decades, we have not given attention to the older adults with diabetic issues because their lifespan was considered short. But we now discovered that 65-70 years old could live up to 85 to 90 years; and so preventing the long term complications is very essential."

The guidelines specifically addresses diabetes issues in adults aged 65 and above. It entails the screening, management and prevention of glycemia, blood pressure and lipids, as well as comorbidities, complications, and specific conditions such as diabetes care in the hospital and long term care facilities, and management of type 1 diabetes in older adults.

We believe there should be frequent screening. For instance, if you screen for pre-diabetes and diabetes in older adults, it can allow you to intervene", LeRoith said.

Prevention of hypoglycemia is a major issue,  coauthor Mark E.  Molitch, MD, of the Northwestern University Feinbery School of Medicine, Chicago, Illinoise told journalists during the briefing.

According to LeRoith in a statement, "A 70 year old who had hypoglycemia and falls on the floor can fracture a hip,  so we have to be extremely careful about preventing hypoglycemia. Similarly, for blood pressure, we don't want to be too aggressive because that can lead to falls. All of these can help adjust medications for older adults with any of these health challenges.

However, other specific aging related comorbidities and challenges addressed in the guidelines include saropenia, cognitive dysfunction, frailty, diminished medication adherence, and loss of independence in daily activities.