The article discusses the prevalence and management of diabetes in older adults, emphasizing the unique challenges and considerations for this age group. More than 25% of U.S. adults aged 65 and older have diabetes, and the aging population is a significant driver of this epidemic. Older adults with diabetes face higher mortality rates, reduced functional status, and increased risk of institutionalization. The American Diabetes Association (ADA) convened a consensus conference to address the epidemiology, pathogenesis, and management of diabetes in older adults. Key points include: - The prevalence of diabetes in older adults ranges from 22% to 33%, with postprandial hyperglycemia being a prominent characteristic. - The incidence of diabetes increases with age until about 65 years, after which it levels off. - Older adults with diabetes have higher rates of major complications such as lower-extremity amputation, myocardial infarction, visual impairment, and end-stage renal disease. - Screening for diabetes and prediabetes is recommended for overweight adults with risk factors and all adults aged 45 years and older. - Prevention and treatment strategies for older adults with diabetes must consider their comorbidities, functional status, and life expectancy. - Glycemic control in older adults is complex, with limited clinical trial data available for many interventions. - Lipid-lowering and blood pressure control are important in older adults with diabetes, but the benefits may vary based on individual characteristics. - Aspirin therapy is recommended for older adults with diabetes and known cardiovascular disease, but the benefits for primary prevention are less clear. - Unique considerations for older adults include cognitive dysfunction, functional impairment, falls, polypharmacy, depression, and sensory impairments. - Nutrition, physical activity, and pharmacotherapy must be tailored to the individual's medical, cultural, and social situation. - Life expectancy is a central concept in geriatric diabetes care, influencing treatment targets and interventions. The article highlights the need for individualized and holistic approaches to managing diabetes in older adults, emphasizing the importance of considering their overall health and life expectancy.The article discusses the prevalence and management of diabetes in older adults, emphasizing the unique challenges and considerations for this age group. More than 25% of U.S. adults aged 65 and older have diabetes, and the aging population is a significant driver of this epidemic. Older adults with diabetes face higher mortality rates, reduced functional status, and increased risk of institutionalization. The American Diabetes Association (ADA) convened a consensus conference to address the epidemiology, pathogenesis, and management of diabetes in older adults. Key points include: - The prevalence of diabetes in older adults ranges from 22% to 33%, with postprandial hyperglycemia being a prominent characteristic. - The incidence of diabetes increases with age until about 65 years, after which it levels off. - Older adults with diabetes have higher rates of major complications such as lower-extremity amputation, myocardial infarction, visual impairment, and end-stage renal disease. - Screening for diabetes and prediabetes is recommended for overweight adults with risk factors and all adults aged 45 years and older. - Prevention and treatment strategies for older adults with diabetes must consider their comorbidities, functional status, and life expectancy. - Glycemic control in older adults is complex, with limited clinical trial data available for many interventions. - Lipid-lowering and blood pressure control are important in older adults with diabetes, but the benefits may vary based on individual characteristics. - Aspirin therapy is recommended for older adults with diabetes and known cardiovascular disease, but the benefits for primary prevention are less clear. - Unique considerations for older adults include cognitive dysfunction, functional impairment, falls, polypharmacy, depression, and sensory impairments. - Nutrition, physical activity, and pharmacotherapy must be tailored to the individual's medical, cultural, and social situation. - Life expectancy is a central concept in geriatric diabetes care, influencing treatment targets and interventions. The article highlights the need for individualized and holistic approaches to managing diabetes in older adults, emphasizing the importance of considering their overall health and life expectancy.