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Approaches to Risk Assessment Among Older Patients With Diabetes

  • Diabetes Epidemiology (E Selvin and K Foti, Section Editors)
  • Published:
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Abstract

Purpose of Review

A patient’s prognosis and risk of adverse drug effects are important considerations for individualizing care of older patients with diabetes. This review summarizes the evidence for risk assessment and proposes approaches for clinicians in the context of current clinical guidelines.

Recent Findings

Diabetes guidelines vary in their recommendations for how life expectancy should be estimated and used to inform the selection of glycemic targets. Readily available prognostic tools may improve estimation of life expectancy but require validation among patients with diabetes. Treatment decisions based on prognosis are difficult for clinicians to communicate and for patients to understand. Determining hypoglycemia risk involves assessing major risk factors; models to synthesize these factors have been developed.

Summary

Applying risk assessment to individualize diabetes care is complex and currently relies heavily on clinician judgment. More research is need to validate structured approaches to risk assessment and determine how to incorporate them into patient-centered diabetes care.

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Funding

SJP was supported by the National Institutes of Health (grant number U01 DK57149). NLS was supported by a career development award from the National Institute on Aging (grant number K76 AG059984). ESH was supported by the National Institutes of Health (grant numbers K24 DK105340, R56 AG051683, P30 DK092949).

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Authors and Affiliations

  1. Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Scott J. Pilla & Nisa M. Maruthur

  2. Welch Center for Prevention, Epidemiology & Clinical Research, Baltimore, MD, USA

    Scott J. Pilla & Nisa M. Maruthur

  3. Department of Medicine, Division of Geriatric Medicine and Gerontology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Nancy L. Schoenborn

  4. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Nisa M. Maruthur

  5. Division of General Internal Medicine, Department of Medicine, The University of Chicago, Chicago, IL, USA

    Elbert S. Huang

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Pilla, S.J., Schoenborn, N.L., Maruthur, N.M. et al. Approaches to Risk Assessment Among Older Patients With Diabetes. Curr Diab Rep 19, 59 (2019). https://doi.org/10.1007/s11892-019-1172-z

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