Pharmacological management of diabetes in older adults
Keywords:
pharmacological management, diabetes, older adultsAbstract
Type 2 diabetes is one of the most prevalent chronic diseases among older adults and represents an increasing therapeutic challenge due to the marked heterogeneity of this population. Comorbidities, cardiovascular disease, chronic kidney disease, frailty, sarcopenia, and cognitive impairment require treatment decisions that extend beyond glycemic control alone.
This presentation will review the main principles guiding pharmacological treatment in older adults with diabetes, integrating current scientific evidence with common clinical scenarios encountered in everyday practice. The role of the available glucose-lowering therapies will be discussed, highlighting their benefits, limitations, and the clinical profiles in which each therapeutic option may provide the greatest value.
Special attention will be given to patients with cardiovascular or renal disease, obesity, frailty, and sarcopenia, as well as to strategies aimed at simplifying treatment regimens, minimizing hypoglycemia, and preserving functional status and quality of life.
References
I. American Diabetes Association Professional Practice Committee. Standards of Care in Diabetes—2026. Diabetes Care. 2026;49(Suppl 1).
II. Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycaemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45(11):2753-2786. doi:10.2337/dci22-0034.
III. Sinclair AJ, Abdelhafiz AH, Rodríguez-Mañas L. Diabetes and frailty: an expert consensus statement. Lancet Diabetes Endocrinol. 2021;9(12):869-880. doi:10.1016/S2213-8587(21)00278-4.
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