Geriatric Syndromes in Older Adults with Diabetes

Joshua J Neumiller; Medha N Munshi

doi:10.1016/j.ecl.2022.10.004

Geriatric Syndromes in Older Adults with Diabetes

Endocrinol Metab Clin North Am. 2023 Jun;52(2):341-353. doi: 10.1016/j.ecl.2022.10.004. Epub 2023 Feb 19.

Authors

Joshua J Neumiller¹, Medha N Munshi²

Affiliations

¹ College of Pharmacy and Pharmaceutical Sciences, Washington State University, 412 East Spokane Falls Boulevard, Spokane, WA 99210, USA. Electronic address: jneumiller@wsu.edu.
² Geriatric Diabetes Program, Joslin Diabetes Centre, Harvard Medical School, 1 Brookline Place, Suite 230, Brookline, MA 02445, USA.

PMID: 36948783
DOI: 10.1016/j.ecl.2022.10.004

Abstract

Over one-quarter of adults ≥65 years old have diabetes in the United States. Guidelines recommend individualization of glycemic targets in older adults with diabetes as well as implementing treatment strategies that minimize risk for hypoglycemia. Patient-centered management decisions should be informed by comorbidities, the individual's capacity for self-care, and the presence of key geriatric syndromes that may impact self-management and patient safety. Key geriatric syndromes include cognitive impairment, depression, functional impairments (eg, vision, hearing, and mobility challenges), falls and fractures, polypharmacy, and urinary incontinence. Screening for geriatric syndromes in older adults is recommended to inform treatment strategies and optimize outcomes.

Keywords: Complications; Deintensification; Glycemic targets; Hypoglycemia; Individualized care; Insulin; Medication safety; Simplification.

Publication types

Review

MeSH terms

Aged
Cognitive Dysfunction*
Comorbidity
Diabetes Mellitus* / epidemiology
Diabetes Mellitus* / therapy
Humans
Hypoglycemia*
Syndrome