Transforming Diabetes Care in Older Adults: A Review of Epidemiology, Challenges, and Personalized Management

As the global elderly population expands, world faces a rapid demographic transformation characterized by a significant increase in life expectancy and a rising prevalence of chronic conditions, notably Type 2 Diabetes Mellitus (T2DM). This review explores the multifaceted challenges associated with diabetes management in older adults, focusing on the urgent need for personalized intervention strategies. This demographic shift creates complex health needs, necessitating comprehensive management approaches tailored to the unique physiological and psychosocial factors affecting older patients. We discuss the epidemiology of T2DM in the elderly and its underlying mechanisms, including insulin resistance and the role of lifestyle factors. The review also highlights the critical importance of early detection and prevention strategies, particularly for prediabetes, and emphasizes the necessity of individualized treatment plans that address varied health statuses and functional capacity among older patients. We address the limitations of current therapeutic approaches, which often derive from studies with younger cohorts, underscoring the need for more age-specific research. Additionally, challenges such as polypharmacy, increased risk of comorbidities, and the potential for adverse treatment outcomes further complicate diabetes care in this age group. We advocate for holistic, integrated care strategies that encompass lifestyle modifications, health education, and appropriate pharmacological interventions, emphasizing patient-centered approaches that factor in the preferences and circumstances of older adults. By addressing these issues, we aim to improve the overall health outcomes, functional capacity, and quality of life for elderly individuals living with T2DM. © 2025 Anastasia V. Poznyak, et al.