ADA, AGS issue consensus report on diabetes in older adults
The American Diabetes Association (ADA) and the American Geriatrics Society (AGS) released a joint consensus report last month on diabetes in older adults.
The American Diabetes Association (ADA) and the American Geriatrics Society (AGS) released a joint consensus report last month on diabetes in older adults.
The consensus report was developed after an ADA-convened consensus development conference in February 2012 that focused on diabetes and older adults (i.e., those at least 65 years of age). The following questions were examined:
- What are the epidemiology and pathogenesis of diabetes in older adults?
- What is the evidence for preventing and treating diabetes and its common comorbidities in older adults?
- What current guidelines exist for treating diabetes in older adults?
- What issues need to be considered in individualizing treatment recommendations for older adults?
- What are consensus recommendations for treating older adults with or at risk for diabetes?
- How can gaps in the evidence best be filled?
The writing group examined the evidence on screening methods for diabetes, prediabetes, and chronic diabetes complications; prevention or delay of type 2 diabetes; and interventions to treat diabetes (including glycemic control, lipid lowering and blood pressure control). It looked at existing guidelines and determined which specifically address diabetes in older adults and which do not include detailed recommendations by age group. Individualized treatment, the writing group said, should examine comorbid conditions and geriatric syndromes (including functional impairment, polypharmacy, depression, and vision and hearing impairment), nutrition issues, physical activity and fitness, and age-specific aspects of pharmacotherapy, among other factors.
The report includes a framework for determining treatment goals in regards to glycemia, blood pressure and dyslipidemia in this population, along with additional consensus recommendations for screening and prevention, management, pharmacotherapy, and care in settings outside the home. Future research, the report said, should include more frail older patients with multiple comorbidities and should focus more on “real world” settings.
The full report was co-published Oct. 25 by Diabetes Care and the Journal of the American Geriatrics Society.