TY - JOUR
T1 - Type 2 diabetes mellitus in older adults
T2 - clinical considerations and management
AU - Bellary, Srikanth
AU - Kyrou, Ioannis
AU - Brown, James E.
AU - Bailey, Clifford J.
PY - 2021/9
Y1 - 2021/9
N2 - The past 50 years have seen a growing ageing population with an increasing prevalence of type 2 diabetes mellitus (T2DM); now, nearly half of all individuals with diabetes mellitus are older adults (aged ≥65 years). Older adults with T2DM present particularly difficult challenges. For example, the accentuated heterogeneity of these patients, the potential presence of multiple comorbidities, the increased susceptibility to hypoglycaemia, the increased dependence on care and the effect of frailty all add to the complexity of managing diabetes mellitus in this age group. In this Review, we offer an update on the key pathophysiological mechanisms associated with T2DM in older people. We then evaluate new evidence relating particularly to the effects of frailty and sarcopenia, the clinical difficulties of age-associated comorbidities, and the implications for existing guidelines and therapeutic options. Our conclusions will focus on the effect of T2DM on an ageing society.
AB - The past 50 years have seen a growing ageing population with an increasing prevalence of type 2 diabetes mellitus (T2DM); now, nearly half of all individuals with diabetes mellitus are older adults (aged ≥65 years). Older adults with T2DM present particularly difficult challenges. For example, the accentuated heterogeneity of these patients, the potential presence of multiple comorbidities, the increased susceptibility to hypoglycaemia, the increased dependence on care and the effect of frailty all add to the complexity of managing diabetes mellitus in this age group. In this Review, we offer an update on the key pathophysiological mechanisms associated with T2DM in older people. We then evaluate new evidence relating particularly to the effects of frailty and sarcopenia, the clinical difficulties of age-associated comorbidities, and the implications for existing guidelines and therapeutic options. Our conclusions will focus on the effect of T2DM on an ageing society.
KW - Age Factors
KW - Aged
KW - Aged, 80 and over
KW - Aging/physiology
KW - Comorbidity
KW - Diabetes Mellitus, Type 2/diagnosis
KW - Frailty/complications
KW - Humans
KW - Prevalence
KW - Sarcopenia/complications
UR - https://www.nature.com/articles/s41574-021-00512-2
UR - http://www.scopus.com/inward/record.url?scp=85108838466&partnerID=8YFLogxK
U2 - 10.1038/s41574-021-00512-2
DO - 10.1038/s41574-021-00512-2
M3 - Review article
C2 - 34172940
AN - SCOPUS:85108838466
SN - 1759-5029
VL - 17
SP - 534
EP - 548
JO - Nature Reviews Endocrinology
JF - Nature Reviews Endocrinology
IS - 9
ER -