The natural history of diabetes in older adults differs from that in younger patients, partly because of shorter life expectancy, increased comorbidity, and a greater risk of treatment-related complications.¹

• 50-80% of adults >65 years of age have diabetes or prediabetes.²
• 61% of all expenditures attributed to diabetes are incurred by patients >65 years. ³
• Older adults with diabetes havehigher complication rates than younger cohorts.³
• One-third of all people with diabetes are >65 years.⁴

Diabetes management strategies for high-functioning older people with long life expectancies are similar to those used in younger patients.¹Life expectancy is an important factor in treatment decisions for older patients near the end of life. As morbidity and functional impairment increase, the anticipated benefit of glycemic control declines.²

Algorithm to Simplify Insulin Regimen in Older Adults with T2DM.⁵

Resources

American Diabetes Association. 12. Older Adults: Standards of Medical Care in Diabetes—2020. Diabetes Care.2020;43(Supplement 1):S152-S162.

References

1. Strain WD, et al. Type 2 diabetes mellitus in older people: a brief statement of key principles of modern day management including the assessment of frailty. A national collaborative stakeholder initiative. Diabetic Medicine. 2018;35(7):838-845. ​
2. Halter JB, et al. Diabetes and cardiovascular disease in older adults: current status and future directions. Diabetes. 2014;63(8):2578-2589.
3. Leung E, et al. Diabetes management in the elderly. Diabetes Spectrum. 2018;31(3):245-253.
4. Schernthaner G, Schernthaner-Reiter MH. Diabetes in the older patient: heterogeneity requires individualisation of therapeutic strategies. Diabetologia. 2018;61(7):1503-1516.  
5. American Diabetes Association. 12. Older Adults: Standards of Medical Care in Diabetes—2020. Diabetes Care.2020;43(Supplement 1):S152-S162.