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Diabetes Management in Older Adults With Chronic Kidney Disease

  • Microvascular Complications—Nephropathy (M Afkarian and B Roshanravan, Section Editors)
  • Published:
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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.

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Funding

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).

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Authors and Affiliations

  1. Department of Medicine, Division of Endocrinology, Western University, London, Ontario, Canada

    Kristin K. Clemens

  2. Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada

    Kristin K. Clemens

  3. St. Joseph’s Health Care London, London, Ontario, Canada

    Kristin K. Clemens & Niamh O’Regan

  4. Institute for Clinical Evaluative Sciences, Ontario, Canada

    Kristin K. Clemens

  5. Lawson Health Research Institute, London, Ontario, Canada

    Kristin K. Clemens & Niamh O’Regan

  6. Department of Medicine, Division of Geriatric Medicine, Western University, London, Ontario, Canada

    Niamh O’Regan

  7. Department of Medicine, Division of Nephrology, Stanford University School of Medicine, Stanford, CA, USA

    Jinnie J. Rhee

Authors
  1. Kristin K. Clemens
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  2. Niamh O’Regan
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  3. Jinnie J. Rhee
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Corresponding author

Correspondence to Kristin K. Clemens.

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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.

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This article is part of the Topical Collection on Microvascular Complications—Nephropathy

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Clemens, K.K., O’Regan, N. & Rhee, J.J. Diabetes Management in Older Adults With Chronic Kidney Disease. Curr Diab Rep 19, 11 (2019). https://doi.org/10.1007/s11892-019-1128-3

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