Jaiwant Rangi, MD, FACEEndocrinologist | Founder, Lower The Dose® | Speaker

Understanding the Nuances of Elderly Diabetes Management

16 Jul 2026 · 1 min

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0:37

In this segment of a clinical talk, the speaker distinguishes two forms of diabetes common in older adults—age‑related diabetes and metabolic diabetes. For both, the preferred pharmacologic regimen includes metformin and DPP‑4 inhibitors, while sulfonylureas are discouraged because of the heightened risk of hypoglycemia in the elderly. Beyond medication, the speaker stresses the importance of resistance training to preserve muscle mass and balance exercises to reduce fall risk, noting that many older patients have reduced muscle and may be vitamin D deficient. Consequently, screening for and correcting vitamin D deficiency is recommended as part of comprehensive diabetes care in seniors.

Chapters

The last two left are age-related and the metabolic diabetes. The age-related respond to metformin and DPP-4 inhibitors, but we'd like to avoid sulfonylureas in elderly because of risk of low blood sugars, and they also benefit from resistance training. So that is a common denominator for all of these. We also want elderly to get balance exercises because their risk of fall goes up because they already have less muscle mass, and sometimes they have vitamin D deficiency, so I always look at other effects and improve on, work on that as well.