Diabetes in Older Persons

Description

Type 2 diabetes is increasingly prevalent among older adults, with nearly one in five South Africans over 65 living with the condition. This population faces a high burden of comorbidities— including cardiovascular disease, chronic kidney disease, arthritis, and cognitive decline—that complicate management and heighten the risk of complications. Pharmacists play a vital role in reviewing prescriptions, preventing overtreatment, minimising hypoglycaemia, and supporting person-centred care. Glycaemic targets should be individualised: tighter control may be suitable for healthier older patients, while more relaxed targets are safer for frail individuals or those with limited life expectancy. Evidence now strongly supports the use of SGLT2 inhibitors and GLP-1 receptor agonists for cardiorenal protection in older patients, though weight loss effects require careful monitoring in frail individuals. Pharmacists can improve outcomes through medication optimisation, deprescribing when appropriate, and patient education, ensuring therapies align with quality of life, comorbidity burden, and individual preferences.

Learning Objectives

After completing this activity, pharmacists should be able to:

• identify comorbidities associated with type 2 diabetes;
• implement glycaemic targets for older persons;
• recommend medications for type 2 diabetes in an older person.

Expires 31st December 2025