Treatment of Diabetes in Older Adults: An Endocrine Society* Clinical Practice Guideline

J Clin Endocrinol Metab. 2019 May 1;104(5):1520-1574. doi: 10.1210/jc.2019-00198.


Objective: The objective is to formulate clinical practice guidelines for the treatment of diabetes in older adults.

Conclusions: Diabetes, particularly type 2, is becoming more prevalent in the general population, especially in individuals over the age of 65 years. The underlying pathophysiology of the disease in these patients is exacerbated by the direct effects of aging on metabolic regulation. Similarly, aging effects interact with diabetes to accelerate the progression of many common diabetes complications. Each section in this guideline covers all aspects of the etiology and available evidence, primarily from controlled trials, on therapeutic options and outcomes in this population. The goal is to give guidance to practicing health care providers that will benefit patients with diabetes (both type 1 and type 2), paying particular attention to avoiding unnecessary and/or harmful adverse effects.

Publication types

  • Practice Guideline
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accidental Falls
  • Aged
  • Aged, 80 and over
  • Atherosclerosis / therapy
  • Continuity of Patient Care
  • Diabetes Complications / therapy*
  • Diabetes Mellitus, Type 1 / therapy*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / prevention & control
  • Diabetes Mellitus, Type 2 / therapy*
  • Diabetic Nephropathies / therapy
  • Diabetic Neuropathies / therapy
  • Diabetic Retinopathy / therapy
  • Disease Management
  • Endocrinologists
  • Heart Failure / therapy
  • Humans
  • Hyperlipidemias / therapy
  • Hypertension / therapy
  • Hypoglycemic Agents / therapeutic use*
  • Life Style*
  • Mass Screening
  • Physician's Role
  • Prediabetic State / diagnosis
  • Renal Insufficiency, Chronic / therapy


  • Hypoglycemic Agents