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Diabetes Management in Older Adults With Chronic Kidney Disease

  • Kristin K. ClemensEmail author
  • Niamh O’Regan
  • Jinnie J. Rhee
Microvascular Complications—Nephropathy (M Afkarian and B Roshanravan, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Microvascular Complications—Nephropathy

Abstract

Purpose of Review

Older adults often live with chronic disease including diabetes and its complications. In this review, we examine the complexity and heterogeneity of older adults with diabetes and chronic kidney disease, explore the nuances in their diabetes-related monitoring, and discuss their best diabetes management.

Recent Findings

Although there remains an overall lack of studies in older adults with diabetes and chronic kidney disease, recent reports have highlighted their vulnerabilities. These individuals face an increased risk of cognitive impairment and dementia, frailty, dysglycemia, polypharmacy, declining kidney function, and acute kidney injury. Their diabetes management should focus upon safer antihyperglycemic medications, close monitoring, and care individualization.

Summary

Older adults with diabetes and chronic kidney disease are a complex population who requires careful diabetes management and monitoring. Research efforts might focus on improving the care and outcomes of these patients.

Keywords

Diabetes Older adults Chronic kidney disease Antihyperglycemic medications Frailty Hypoglycemia Comorbidity 

Notes

Funding Information

Kristin K. Clemens reports grants from the Canadian Institutes of Health Research/Strategy for Patient Oriented Research and grants from Western University. Niamh O’Regan reports a grant from the Academic Medical Organization of Southwestern Ontario. Jinnie J. Rhee reports grants from National Institutes of Health/National Institute of Diabetes and Digestive and Kidney Diseases (K01 Research Scientist Career Development Award).

Compliance with Ethical Standards

Conflict of Interest

Kristin K. Clemens received a 2017 Diabetes Canada Junior Investigator Award funded by AstraZeneca outside of the submitted work. She has also received conference support from Merck Inc.

Niamh O’Regan and Jinnie J. Rhee declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Kristin K. Clemens
    • 1
    • 2
    • 3
    • 4
    • 5
    Email author
  • Niamh O’Regan
    • 3
    • 5
    • 6
  • Jinnie J. Rhee
    • 7
  1. 1.Department of Medicine, Division of EndocrinologyWestern UniversityLondonCanada
  2. 2.Department of Epidemiology and BiostatisticsWestern UniversityLondonCanada
  3. 3.St. Joseph’s Health Care LondonLondonCanada
  4. 4.Institute for Clinical Evaluative SciencesOntarioCanada
  5. 5.Lawson Health Research InstituteLondonCanada
  6. 6.Department of Medicine, Division of Geriatric MedicineWestern UniversityLondonCanada
  7. 7.Department of Medicine, Division of NephrologyStanford University School of MedicineStanfordUSA

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