The management of diabetes in older adults requires a nuanced approach that prioritizes quality of life and safety over intensive glycemic targets. These flashcards are designed to help pharmacists and healthcare professionals quickly recall the 2018 Clinical Practice Guidelines regarding functional status assessment, the risks of overtreatment, and the specific pharmacologic adjustments needed to protect the aging brain and body.
Key Topics Covered:
Personalized Targets: Memorizing the A1C targets based on frailty: 7.0% for functionally independent adults versus 7.1%–8.5% for those who are frail or have dementia.
Hypoglycemia & Dementia: Understanding the dangerous bidirectional relationship between severe hypoglycemia and cognitive decline.
Medication Safety: Identifying glyburide as a medication to avoid due to prolonged hypoglycemia risk and recognizing the preference for DPP-4 inhibitors or shorter-acting agents.
De-intensification: Knowing when and how to simplify insulin regimens or reduce pill burdens to prevent adverse events in complex patients.
Institutional Care: Recalling that for residents in long-term care, the primary goals are maintaining comfort, preventing symptomatic hyperglycemia, and avoiding hypoglycemia rather than achieving strict metabolic targets.