Older Adults: 2019 Standards of Medical Care in Diabetes

The Endocrine Society has issued guidelines on screening for, and treating diabetes in patients aged 65 and older.

They were presented on Saturday, March 30th, at the group's annual meeting and published in the Journal of Clinical Endocrinology & Metabolism.

Among the highlights:

  • Outpatient diabetes regimens should be geared toward minimizing risk for hypoglycemia. Accordingly, first-line treatment should be metformin; oral agents with high risk for hypoglycemia should be avoided (e.g., sulfonylureas and glinides); and insulin should be used sparingly.
     
  • In patients with prediabetes, focus on lifestyle modification; metformin is not recommended for this population.
     
  • Diabetic patients should be screened periodically for cognitive impairment. For those who screen positive, diabetes regimens should be simplified to facilitate adherence and help prevent treatment-related complications; glycemic targets should also be more lenient.
     

VillageIMG providers will review treatment guidelines with you during your next office visit, and make changes if indicated. 

Metformin has always been our first choice (unless intolerance or contraindications) and we have always tried to avoid the of use of sulfonylureas (chosen only when forced by cost).

 

See http://care.diabetesjournals.org/content/42/Supplement_1/S139 for more information.