Type 2 diabetes

The Lancet, Journal Year: 2022, Volume and Issue: 400(10365), P. 1803 - 1820

Published: Nov. 1, 2022

Language: Английский

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Management of Type 2 Diabetes Mellitus in Elderly Patients with Frailty and/or Sarcopenia

International Journal of Environmental Research and Public Health, Journal Year: 2022, Volume and Issue: 19(14), P. 8677 - 8677

Published: July 16, 2022

The life expectancy of the population is increasing worldwide due to improvements in prevention, diagnosis, and treatment diseases. This favors a higher prevalence type 2 diabetes mellitus (T2DM) elderly. Sarcopenia frailty are also frequently present aging. These three entities share common mechanisms such as insulin resistance, chronic inflammation, mitochondrial dysfunction. coexistence these situations worsens prognosis elderly patients. In this paper, we review main measures for prevention management sarcopenia and/or patients with T2DM.

Language: Английский

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Comparative Cardiovascular Effectiveness and Safety of SGLT-2 Inhibitors, GLP-1 Receptor Agonists, and DPP-4 Inhibitors According to Frailty in Type 2 Diabetes

Diabetes Care, Journal Year: 2023, Volume and Issue: 46(11), P. 2004 - 2014

Published: Sept. 7, 2023

To evaluate the comparative cardiovascular effectiveness and safety of sodium-glucose cotransporter 2 inhibitors (SGLT-2is), glucagon-like peptide 1 receptor agonists (GLP-1RAs), dipeptidyl peptidase 4 (DPP-4is) in older adults with type diabetes (T2D) across different frailty strata.

Language: Английский

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A Proposed Curricular Framework for an Interprofessional Approach to Deprescribing

Medical Science Educator, Journal Year: 2023, Volume and Issue: 33(2), P. 551 - 567

Published: Feb. 23, 2023

Deprescribing involves reducing or stopping medications that are causing more harm than good no longer needed. It is an important approach to managing polypharmacy, yet healthcare professionals identify many barriers. We present a proposed pre-licensure competency framework describes essential knowledge, teaching strategies, and assessment protocols promote interprofessional deprescribing skills. The considers how involve patients care partners in decisions. An action plan example curriculum mapping exercise included help educators assess their curricula, select implement these concepts strategies within programs ensure learners graduate with competencies manage increasingly complex medication regimens as people age.The online version contains supplementary material available at 10.1007/s40670-022-01704-9.

Language: Английский

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Sodium-glucose cotransporter-2 inhibitors (SGLT2) in frail or older people with type 2 diabetes and heart failure: a systematic review and meta-analysis

Age and Ageing, Journal Year: 2024, Volume and Issue: 53(1)

Published: Jan. 1, 2024

Abstract Objective Sodium-glucose cotransporter-2 inhibitors (SGLT2Is) reduce cardio-metabolic and renal outcomes in patients with type 2 diabetes (T2D) but their efficacy safety older or frail individuals remains unclear. Methods We searched PubMed, Scopus, Web of Science, Cochrane CENTRA Google Scholar selected randomised controlled trials observational studies comparing SGLT2Is versus placebo/other glucose-lowering agent for people frailty (>65 years) T2D heart failure (HF). Extracted data on the change HbA1c % were pooled a random-effects meta-analysis model. Results included from 20 (22 reports; N = 77,083 patients). did not significantly level (mean difference −0.13, 95%CI: −0.41 to 0.14). associated significant reduction risk all-cause mortality (risk ratio (RR) 0.81, −0.69 0.95), cardiac death (RR 0.80, −0.94 0.69) hospitalisation (HHF) 0.69, 0.59–0.81). However, demonstrate effect reducing macrovascular events (acute coronary syndrome cerebral vascular occlusion), progression/composite endpoint, acute kidney injury, worsening HF, atrial fibrillation diabetic ketoacidosis. Conclusions In are consistently linked decrease total overall burden cardiovascular (CV) events, including HHF death, protective events. Adverse more difficult quantify ketoacidosis injury was increase.

Language: Английский

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Network analysis of depressive and anxiety symptoms in older Chinese adults with diabetes mellitus

Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 15

Published: Jan. 29, 2024

Background The move away from investigating mental disorders as whole using sum scores to the analysis of symptom-level interactions network has provided new insights into comorbidities. current study explored dynamic between depressive and anxiety symptoms in older Chinese adults with diabetes mellitus (DM) identified central bridge depression-anxiety provide potential targets for prevention intervention depression anxiety. Methods This used a cross-sectional design data 2017–2018 wave Longitudinal Healthy Longevity Survey (CLHLS). A regularized partial correlation was estimated based on self-reported scales completed by 1685 DM aged 65 years or older. Depressive were assessed 10-item Center Epidemiologic Studies Depression Scale (CESD-10) Seven-Item Generalized Anxiety Disorder (GAD-7), respectively. Expected influence (EI) expected (BEI) indices calculated each symptom. Results According cutoff indicating presence anxiety, prevalences our sample 52.9% 12.8%, comorbidity rate 11.5%. six edges strongest correlations same disorder. “Feeling blue/depressed”, “Nervousness anxiety”, “Uncontrollable worry”, “Trouble relaxing”, “Worry too much” had highest EI values. anxiety” “Everything an effort” exhibited BEI Conclusion Central highlighted this study. Targeting these may be effective preventing facilitate interventions who are at risk currently have symptoms.

Language: Английский

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Guideline for the Management of Diabetes Mellitus in the Elderly in China (2024 Edition)

Aging Medicine, Journal Year: 2024, Volume and Issue: 7(1), P. 5 - 51

Published: Feb. 1, 2024

Abstract With the deepening of aging in China, prevalence diabetes older people has increased noticeably, and standardized management is critical for improving clinical outcomes people. In 2021, National Center Gerontology, Chinese Society Geriatrics, Diabetes Professional Committee Aging Well Association organized experts to write first guideline diagnosis treatment Guideline Management Mellitus Elderly China (2021 Edition) . The emphasizes that patients with are a highly heterogeneous group requiring comprehensive assessment stratified individualized strategies. proposes simple treatments de‐intensified strategies diabetes. This edition provides clinicians practical operable guidance, thus greatly contributing full‐cycle promoting extensive development basic research on related fields. past 3 years, evidence‐based medicine fields further advanced, new concepts, drugs, technologies have been developed. editorial committee promptly updated compiled (2024 More precise paths proposed, achieving continued standardization their outcomes.

Language: Английский

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Age and Sex Differences in Efficacy of Treatments for Type 2 Diabetes

JAMA, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 3, 2025

Importance Sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and dipeptidyl peptidase 4 (DPP4) inhibitors improve hyperglycemia, SGLT2 GLP-1 agonists reduce the risk of major adverse cardiovascular events (MACEs) among individuals with type diabetes. It is not clear whether efficacy varies by age or sex. Objective To assess sex are associated differences in DPP4 inhibitors. Data Sources Study Selection The MEDLINE Embase databases US Chinese clinical trial registries were searched for articles published from inception to November 2022; August 2024, search was updated capture results. Two reviewers screened randomized trials vs a placebo active comparator adults Extraction Synthesis Individual participant data aggregate used estimate × treatment interactions multilevel network meta-regression models. Main Outcome Measures Hemoglobin A 1c (HbA ) MACEs. Results Of 601 eligible identified (592 309 503 participants reported HbA ; mean age, 58.9 [SD, 10.8] years; 42.3% female 23 168 489 MACEs; 64.0 8.6] 35.3% female), individual obtained 103 (103 6 MACEs). use (vs placebo) less lowering increasing monotherapy (absolute reduction [AR], 0.24% [95% credible interval {CrI}, 0.10% 0.38%] per 30-year increment age), dual therapy (AR, 0.17% CrI, 0.24%]), triple 0.25% 0.20% 0.30%]). greater −0.18% −0.31% −0.05%] age) −0.24% −0.40% −0.07%]), but 0.04% −0.02% 0.11%]). slightly better older people −0.09% −0.15% −0.03%] −0.08% 0.01%]) −0.01% −0.06% 0.05%]). relative MACEs younger (hazard ratio, 0.76 0.62 0.93]), 1.47 1.07 2.02]). There no consistent evidence agonists. Conclusions Relevance lower Analysis suggested that more cardioprotective than despite smaller reductions people.

Language: Английский

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Fracture risk following bariatric surgery: a systematic review and meta-analysis

Osteoporosis International, Journal Year: 2022, Volume and Issue: 33(3), P. 511 - 526

Published: Jan. 5, 2022

Language: Английский

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Frailty and diabetes in older adults: Overview of current controversies and challenges in clinical practice

Frontiers in Clinical Diabetes and Healthcare, Journal Year: 2022, Volume and Issue: 3

Published: Aug. 19, 2022

OPINION article Front. Clin. Diabetes Healthc., 19 August 2022Sec. Inequalities Volume 3 - 2022 | https://doi.org/10.3389/fcdhc.2022.895313

Language: Английский

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