Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Optimal Type 2 Diabetes Mellitus Management and Active Ageing

Version 1 : Received: 2 August 2021 / Approved: 3 August 2021 / Online: 3 August 2021 (09:07:51 CEST)

A peer-reviewed article of this Preprint also exists.

Calabrese, A.M.; Calsolaro, V.; Rogani, S.; Okoye, C.; Caraccio, N.; Monzani, F. Optimal Type 2 Diabetes Mellitus Management and Active Ageing. Endocrines 2021, 2, 523-539. Calabrese, A.M.; Calsolaro, V.; Rogani, S.; Okoye, C.; Caraccio, N.; Monzani, F. Optimal Type 2 Diabetes Mellitus Management and Active Ageing. Endocrines 2021, 2, 523-539.

Abstract

Type two diabetes mellitus (T2DM) represents a chronic condition with increasing prevalence worldwide among the older population. T2DM condition increases the risk of micro and macro-vascular complications as well as the risk of geriatric syndromes as falls, fractures and cognitive impairment. The management of T2DM in the older population represents a challenge for the cli-nician, and a Comprehensive Geriatric Assessment should always be prioritized, in order to tailor the glycate haemoglobin target according to functional and cognitive status comorbidities, life ex-pectancy and type of therapy. According to the most recent guidelines, older adults with T2DM should be cathegorized in three groups: healthy patients with good functional status, patients with complications and reduced functionality and patients at the end of life; for each group the target for the glycemic control is different, also according to the type of treatment drug. The therapeutic ap-proach should always begin with lifestyle changes; after that, several lines of therapies are available, with different mechanism of action and potential effect other than glucose level reduction. Partic-ular interest is growing around sodium-glucose cotransporter-2 inhibitors, due to their effect on the cardiovascular system. In this review we evaluate the therapeutic options available for the treat-ment of older diabetic patients, to ensure a correct treatment approach

Keywords

type 2 diabetes mellitus (T2DM); older people; frailty; antidiabetic drugs; comprehensive geriatric assessment; therapeutic targets; hypoglycemia.

Subject

Medicine and Pharmacology, Immunology and Allergy

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