Q&A: Derek LeRoith, MD, PhD, Discusses Society Guideline on Treating Older Patients with Diabetes

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Endocrine News talks with Derek LeRoith MD, PhD, chair of the guideline writing committee that created the latest Endocrine Society Clinical Practice Guideline on Treatment of Diabetes in Older Adults.

Simplifying medication regimens and tailoring glycemic targets in older adults with diabetes improves adherence and avoids treatment-related complications, according to the latest clinical practice guideline released by the Endocrine Society during ENDO 2019 in New Orleans in March.

Entitled “Treatment of Diabetes in Older Adults: An Endocrine Society Clinical Practice Guideline,” the guideline was published online in March and will appear in the May 2019 print issue of The Journal of Clinical Endocrinology & Metabolism.

Derek LeRoith MD, PhD, director of research, Division of Endocrinology, Diabetes and Bone Diseases, Icahn School of Medicine at Mt. Sinai, New York, is the chair of the writing committee that authored this guideline. “The guideline encourages clinicians to consider available evidence, a patient’s overall health, their likelihood to benefit from interventions, and their personal values when considering treatment goals such as glucose, blood pressure, and cholesterol,” says LeRoith. “Our framework prioritizes blood glucose targets over the hemoglobin A1c test when managing diabetes in older adults.”

LeRoith shares his thoughts with Endocrine News about how this new guideline will impact treating this patient population and how it could impact other medical specialties.

Endocrine News: What was the main reason for the publication of the diabetes in older adults guideline. What drove the decision and why now?

Derek LeRoith: The incidence of diabetes in the older population (over the age of 65 years) is much greater than those in the younger age group. It was therefore important to us as endocrinologists to highlight the need for more attention to this age group, both in making the diagnosis and instituting the correct therapies.

EN: What are your hopes for the impact of the guideline on endocrine standards of care for older patients with diabetes?
DL: We believe that the guidelines will enable the health professional to pay more attention to the elderly patient with diabetes, both therapeutically and to avoid many of the hazards and complications that occur with this population.

Diabetes is more common in the elderly and they require treatment similar to the younger diabetic population with special care regarding acute complications in addition to preventing the long-term complications.

EN: How do you expect other medical specialties to be affected by this guideline’s recommendations?
DL: The guidelines not only address the general medical health providers but other subspecialties that deal with diabetic complications, including nephrologists, eye specialists, surgeons, etc.

EN: What are the key take-home messages for patients in this guideline?
DL: The key take-home messages are diabetes is more common in the elderly and they require treatment similar to the younger diabetic population, with special care regarding acute complications, in addition to preventing the long-term complications.

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