AACE MENA 2025-Diabetes Management in the Older Adult

Video Transcription

Video Summary

The speaker discusses diabetes management in older adults, emphasizing the significance of aging populations with high diabetes prevalence. They define older adults not only by age (65+) but by functional status, dividing them into healthy, complex, and frail categories, affecting treatment decisions. Special concerns include increased hypoglycemia risk, cognitive impairment, frailty, polypharmacy, and social factors. Assessment should prioritize safety, functionality, and quality of life over strict glycemic control, using tools like Mini-COG for cognitive screening. Lifestyle recommendations focus on nutrition and resistance exercise. Pharmacologic treatment favors metformin, with caution in frail patients, and possible addition of SGLT2 inhibitors or GLP-1 receptor agonists for cardiovascular benefits. Sulfonylureas and complex insulin are avoided when hypoglycemia risk is high. Treatment should be individualized, aiming for realistic glycemic targets while regularly reassessing as patients’ functional status changes. Integrating diabetes care within a comprehensive geriatric assessment is crucial.

Keywords

diabetes management

older adults

hypoglycemia risk

cognitive impairment

pharmacologic treatment

geriatric assessment