Recommendations: Older Adults (2)
Recommendations for the care of diabetes in older adults1 are summarized in two slides Slide 2 of 2 Other cardiovascular risk factors should be treated in older adults with consideration of the time frame of benefit and the individual patient (E) Treatment of hypertension is indicated in virtually all older adults and lipid and aspirin therapy may benefit those with life expectancy at least equal to the time frame of primary or secondary prevention trials (E) Screening for diabetes complications should be individualized in older adults, but particular attention should be paid to complications that would lead to functional impairment (E) Although control of hyperglycemia may be important in older individuals with diabetes, greater reductions in morbidity and mortality may result from control of other cardiovascular risk factors rather than from tight glycemic control alone There is strong evidence from clinical trials of the value of treating hypertension in the elderly;2,3 there is less evidence for lipid-lowering and aspirin therapy, although the benefits of these interventions for primary and secondary prevention are likely to apply to older adults whose life expectancies equal or exceed the time frames seen in clinical trials129Reference American Diabetes Association. Standards of medical care in diabetes—2013. Diabetes Care 2013;36(suppl 1):S44. Curb JD, Pressel SL, Cutler JA, et al for the Systolic Hypertension in the Elderly Program Cooperative Research Group. Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. JAMA 1996;276:1886-1892. Beckett NS, Peters R, Fletcher AE, et al for the HYVET Study Group. Treatment of hypertension in patients 80 years of age or older. N Engl J Med 2008;358:1887-1898.