Managing Type 2 Diabetes Mellitus in Older Adults

Older adults with type 2 diabetes mellitus often present with multiple comorbidities, functional limitations, and geriatric syndromes that may impact selection of glucose-lowering therapies and patient-specific treatment goals. Screening for common geriatric syndromes, such as cognitive impairment and depression, and avoiding inappropriate polypharmacy are important to optimize treatment outcomes, patient safety, and quality of life. Liberalization of glycemic targets, deintensification of therapy, and/or medication regimen simplification may be beneficial in older adults as their capacity for self-care and treatment goals change over time. Utilization of glucose-lowering regimens that minimize hypoglycemia and therapeutic burden is recommended whenever possible.