Simplified med regimens, tailored glycemic targets recommended for those with cognitive impairment
TUESDAY, March 26, 2019 (HealthDay News) — Recommendations have been developed for the management of diabetes in older adults; the clinical practice guideline was published online March 23 in the Journal of Clinical Endocrinology & Metabolism to coincide with the annual meeting of The Endocrine Society, held from March 23 to 26 in New Orleans.
Derek LeRoith, M.D., Ph.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues formulated guidelines for the treatment of diabetes in older adults.
The authors recommend that an endocrinologist or diabetes care specialist work with the primary care provider, a multidisciplinary team, and the patient to develop individualized diabetes treatment goals. For patients aged 65 years and older, the patient’s overall health and personal values should be assessed before determining treatment goals and strategies; periodic cognitive screening should be performed. Medication regimens should be simplified, and glycemic targets should be tailored for patients with diabetes and cognitive impairment. Outpatient regimens should be designed to minimize hypoglycemia; glycemic targets should be tailored to overall health and management strategies. A blood pressure target of 140/90 mm Hg is recommended for patients aged 65 to 85 years with diabetes; patients in certain high-risk groups could be considered for lower blood pressure targets.
“The guideline encourages clinicians to consider available evidence and a patient’s overall health, likelihood to benefit from interventions and personal values when considering treatment goals such as glucose, blood pressure, and cholesterol,” LeRoith said in a statement.
Several authors disclosed financial ties to the pharmaceutical industry.
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