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GLP-1 Agonists Reduce A1c Levels in Older Patients


Core Concepts
GLP-1 agonists can effectively reduce A1c levels and BMI in older patients with uncontrolled type 2 diabetes, potentially eliminating the need for additional medications.
Abstract
The study presented at the Gerontological Society of America's annual meeting focused on the impact of GLP-1 agonists on older patients with uncontrolled type 2 diabetes. Key highlights include: Reduction in A1c levels and BMI in participants aged 65-84. Education and counseling on diet and lifestyle modifications were provided. GLP-1 agonists led to a reduction in A1c levels to 5.8%-7.7% and BMI to 23-39.8. Deprescription of other medications like insulin and sulfonylureas was possible. GLP-1 agonists can induce remission of type 2 diabetes through weight loss. Weight loss and diabetes control offer cardiovascular protection in these patients.
Stats
Participants had initial A1c levels ranging from 9.6% to 12.6%. BMI ranged from 27 to 48.2. A reduction in A1c to 5.8% to 7.7% was observed. BMI reduced to between 23 and 39.8.
Quotes
"The reduction in BMI that we saw in our patients even though they were still in the category of obesity produces a substantial benefit in the management [of type II diabetes]." - Anna Pendrey, MD "You can induce remission of type 2 diabetes through weight loss that GLP-1s can cause." - Rodolfo Galindo, MD

Key Insights Distilled From

by Lara Salahi at www.medscape.com 11-14-2023

https://www.medscape.com/viewarticle/998478
GLP-1 Drugs Reduced Patient A1c Levels, Need for Other Drugs

Deeper Inquiries

How can the healthcare system better integrate GLP-1 agonists for older patients with type 2 diabetes?

Integrating GLP-1 agonists more effectively into the healthcare system for older patients with type 2 diabetes involves several key strategies. Firstly, healthcare providers should prioritize education and training on the benefits and potential side effects of GLP-1 agonists to ensure proper administration and monitoring. Additionally, establishing clear guidelines and protocols for initiating and adjusting GLP-1 agonist therapy based on individual patient needs and responses is crucial. Collaborative care models involving multidisciplinary teams can help optimize the use of GLP-1 agonists by incorporating input from endocrinologists, primary care physicians, dietitians, and pharmacists. Furthermore, leveraging technology such as telemedicine for remote monitoring and consultations can enhance access to care and improve medication adherence among older patients with diabetes.

What are the potential drawbacks or limitations of relying solely on GLP-1 agonists for diabetes management?

While GLP-1 agonists offer significant benefits in managing type 2 diabetes, there are potential drawbacks and limitations to consider when relying solely on these medications for diabetes management. One limitation is the risk of side effects such as nausea, vomiting, and the potential for dehydration, which may impact medication adherence and quality of life for some patients. Additionally, GLP-1 agonists can increase the risk of pancreatitis, highlighting the importance of close monitoring and regular follow-up with healthcare providers. Another drawback is the potential for weight loss-induced sarcopenia in older adults, necessitating careful consideration of individual patient characteristics and nutritional needs. Furthermore, the cost of GLP-1 agonists may pose a barrier to access for some patients, underscoring the importance of addressing affordability and insurance coverage issues in diabetes management.

How can advancements in diabetes treatment impact overall geriatric care strategies?

Advancements in diabetes treatment, such as the use of GLP-1 agonists, can have a profound impact on overall geriatric care strategies. By focusing on holistic approaches that prioritize weight loss, glucose control, and cardiovascular protection, healthcare providers can improve outcomes for older adults with diabetes. These advancements shift the treatment paradigm towards addressing not only glucose levels but also underlying comorbidities and complications associated with diabetes. Incorporating personalized medicine approaches that consider individual patient needs, preferences, and goals can enhance the effectiveness of diabetes treatment in older adults. Moreover, advancements in diabetes care can inform geriatric care strategies by emphasizing the importance of multidisciplinary care teams, patient education, and ongoing monitoring to optimize outcomes and quality of life for older patients with diabetes.
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