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Cited by 226Diabetes Treatment and ManagementDiabetes Management and EducationDiabetes Management and Research

Diabetes and Aging: unique considerations and goals of care

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Kalyani, Rita R., Golden, Sherita H., Cefalu, William T.·2017·Diabetes Care
DOI 10.2337/dci17-0005PMC PMC5360288
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Abstract

Diabetes in older adults is a growing public health burden. The unprecedented aging of the world's population is a major contributor to the diabetes epidemic, and older adults represent one of the fastest growing segments of the diabetes population. Of impending concern is that these numbers are projected to grow dramatically over the next few decades (1,2). Almost one-third of U.S. adults over the age of 65 years have diabetes. Approximately half of those are undiagnosed, and an additional one-third of older adults have prediabetes (3). Persons with diabetes today are living much longer compared with those in the past. We also recognize that management of older adults with diabetes is clearly more complicated given the observation that they commonly have multiple coexisting medical conditions that can impact clinical management. While rates of diabetes-related complications have declined overall in the general population, the incidence rates of macrovascular complications such as acute myocardial infarction and stroke continue to be the highest in older age-groups. These individuals also have the highest rate of diabetes-related end-stage renal disease (4). Heterogeneity in the health status of older adults (ranging from robust and otherwise healthy individuals to those with frailty and multiple comorbid conditions) and the paucity of evidence from clinical trials represent a challenge to making generalized treatment recommendations for older adults. Although many more individuals with type 1 diabetes are living longer (5), type 2 diabetes remains the most common type in older age-groups. Furthermore, older adults with diabetes may either have elderly onset disease (diagnosed at age 65 years or older) or long-standing diabetes with onset in middle age or earlier years (6), adding to the complexity of managing diabetes in older adults. Consequently, the American Diabetes Association (ADA) organized a Consensus Development Conference on Diabetes and Older Adults …

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  • Older adults with diabetes often require greater caregiver support than those without diabetes.

    “These conditions may affect older adults’ diabetes self-management abilities and quality of life, particularly if unaddressed, and older adults with diabetes often require greater caregiver support than those without diabetes (2,9–11).”

    From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [11]

    The main text (page unavailable) says older adults with diabetes have greater functional decline and that cognitive impairment can affect their ability to self-manage diabetes. It does not say they often require greater caregiver support than older adults without diabetes; searches for caregiver support and assistance found no such comparison. (LLM, conf=0.83)

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  • These conditions may affect older adults' diabetes self-management abilities and quality of life, particularly if unaddressed.

    “These conditions may affect older adults’ diabetes self-management abilities and quality of life, particularly if unaddressed, and older adults with diabetes often require greater caregiver support than those without diabetes (2,9–11).”

    From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [11]

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Research works printed but not linked: 23

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  9. [12]UK Prospective Diabetes Study (UKPDS) Group Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837– 853 9742976
  10. [13]Cruz-Jentoft AJ, Carpena-Ruiz M, Montero-Errasquín B, Sánchez-Castellano C, Sánchez-García E Exclusion of older adults from ongoing clinical trials about type 2 diabetes mellitus. J Am Geriatr Soc 2013; 61: 734– 738 23590338
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  12. [17]Palta P, Huang ES, Kalyani RR, Golden SH, Yeh H-C Hemoglobin A1C and mortality in older adults with and without diabetes: results from the National Health and Nutrition Examination Surveys (1988–2011). Diabetes Care 2017; 40: 453– 460 28223299 PMC5864101
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Authors
Kalyani, R. R., Golden, S. H., & Cefalu, W. T.
Affiliations
  • Johns Hopkins University (US)
  • Pennington Biomedical Research Center (US)
Corresponding author
Kalyani, Rita R.
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2017-03-10
Volume
40
Issue
4
Pages
440-443
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dci17-0005
PMC
PMC5360288
OpenAlex
W2602405428
Cited by
226
References
8
Citations by year
2026: 12 · 2025: 23 · 2024: 23 · 2023: 26 · 2022: 31 · 2021: 41 · 2020: 39 · 2019: 22 · 2018: 7 · 2017: 2
FWCI
15.14
Type
journal article
Language
en
Open access
Licence
www.diabetesjournals.org/content/license (vor, 11 d)
Locations
  • Diabetes Care (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • AstraZeneca
  • Sanofi
  • Intarcia Therapeutics
  • Louisiana Clinical and Translational Science Center
  • Mitsubishi Tanabe Pharma Corporation
  • National Institutes of Health (1U54-GM-104940, which funds the Louisiana Clinical)
  • National Institute of General Medical Sciences (U54GM104940)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R03DK109163, K23DK093583)
  • National Center for Complementary and Integrative Health (P50AT002776)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
diabetes in older adults, aging, goals of care, type 2 diabetes, type 1 diabetes, prediabetes, undiagnosed diabetes, comorbidities, frailty, macrovascular complications, end-stage renal disease, long-standing diabetes, diabetes management

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