Diabetes Management in Older Adults With Chronic Kidney Disease
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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.
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.
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.
KeywordsDiabetes Older adults Chronic kidney disease Antihyperglycemic medications Frailty Hypoglycemia Comorbidity
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.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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