Diabetes Metab J.  2024 Jul;48(4):531-545. 10.4093/dmj.2024.0310.

Holistic and Personalized Strategies for Managing in Elderly Type 2 Diabetes Patients

• Yun JS
• Kim K
• Ahn YB
• Han K
• Ko SH

• KMID: 2558035
• DOI: http://doi.org/10.4093/dmj.2024.0310

Abstract

Due to increased life expectancy and lifestyle changes, the prevalence of diabetes among the elderly in Korea is continuously rising, as is the associated public health burden. Diabetes management in elderly patients is complicated by age-related physiological changes, sarcopenia characterized by loss of muscle mass and function, comorbidities, and varying levels of functional, cognitive, and mobility abilities that lead to frailty. Moreover, elderly patients with diabetes frequently face multiple chronic conditions that elevate their risk of cardiovascular diseases, cancer, and mortality; they are also prone to complications such as hyperglycemic hyperosmolar state, diabetic ketoacidosis, and severe hypoglycemia. This review examines the characteristics of and management approaches for diabetes in the elderly, and advocates for a comprehensive yet personalized strategy.

Keyword

Aged; Diabetes mellitus, type 2; Frailty; Multimorbidity; Precision medicine; Sarcopenia

Figure

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  Fig. 1. Factors contributing to the onset and worsening of type 2 diabetes mellitus in the elderly. IGF-1, insulin-like growth factor-1; AGE, advanced glycation end product; ROS, reactive oxygen species; ESKD, end-stage kidney disease.

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  Fig. 2. Personalized strategies for managing elderly diabetes based on overall health risks and considerations for glucose-lowering medications in the treatment of elderly type 2 diabetes mellitus (T2DM). CV, cardiovascular; SGLT2, sodium glucose co-transporter 2; GLP-1 RA, glucagon-like peptide-1 receptor agonist; UTI, urinary tract infection; GTI, genital tract infection; DKA, diabetic ketoacidosis; DM, diabetes mellitus.

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