New Guideline Emphasizes Simpler Diabetes Regimens, Looser Glycemic Targets for Older Adults

The Endocrine Society has released a new guideline for diabetes treatment in older adults recommending simplified drug regimens and looser glycemic targets to improve adherence and prevent treatment-related complications, reports Healio . The guideline concentrates on treatment approaches considering overall health and quality of life of older diabetics. Regular screening for prediabetes and diabetes is advised, with collaboration between an endocrinologist or diabetes care specialist and the primary care provider, a multidisciplinary team, and the recipient to tailor treatment goals. Also recommended is periodic cognitive screening to identify undiagnosed cognitive impairment in the older population. The guideline authors urge initial cognitive screening at time of diagnosis or entry into a care program, with repeat screening every two to three years following a normal screening test result. Assessment of cognitive impairment and cognition should be performed in older persons with complaints. Medication regimens should be simplified and glycemic targets customized to be more lenient, with the goal to improve compliance and prevent complications related to treatment among older adults with a history of cognitive impairment. The guideline recommends lifestyle modification as the first-line treatment for hyperglycemia in ambulatory older adults, while other recommendations include evaluating nutritional status for signs of malnutrition, and a protein- and energy-rich diet. Metformin is the initial recommended oral medication.