Diabetes Management in Older Adults With Chronic Kidney Disease

Curr Diab Rep. 2019 Feb 15;19(3):11. doi: 10.1007/s11892-019-1128-3.


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. 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: Antihyperglycemic medications; Chronic kidney disease; Comorbidity; Diabetes; Frailty; Hypoglycemia; Older adults.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Diabetes Complications / complications
  • Diabetes Complications / therapy
  • Diabetic Nephropathies / complications
  • Diabetic Nephropathies / therapy*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Monitoring, Physiologic
  • Precision Medicine
  • Renal Insufficiency, Chronic / complications
  • Renal Insufficiency, Chronic / therapy*


  • Hypoglycemic Agents