Diabetes

Older adults with diabetes are a heterogeneous population in terms of comorbidities, functional ability, mental health and psychosocial issues, support system, location of care, staff competencies, and practitioner preferences. Hence, the care of these individuals is challenging and requires an individualized, creative, and person-centered approach. A systematic and careful evaluation of their health and comorbidities, diabetes self-management skills, hypoglycemia risk, mobility, cognitive and functional status, and affordability of medications is recommended. Over time, medical complexity will increase, with the background of concurrent geriatric syndromes and frailty. Older adults with diabetes are likely to experience one or more care transitions and may eventually need thoughtful discussions for planning care at the end of life. The authors will also discuss a case-based approach to medication management, glycemic goals, avoidance of hypoglycemia, and improving care transitions.