Table 3.
Open questions in research on diabetes and frailty in older adults
| Research area | Open questions |
|---|---|
| Pharmacological research | – What are the long-term effects of SGLT2 inhibitors and GLP-1 receptor agonists on frailty and sarcopenia in older adults? |
| – Can dual agonists (e.g., tirzepatide) provide significant benefits in frail populations without exacerbating muscle loss? | |
| Glycaemic targets and safety | – What are the optimal HbA1c targets for different degrees of frailty in older adults? |
| – How can hypoglycaemia risk in frail patients be better predicted and mitigated? | |
| Technology in diabetes management | – How effective are AI-driven tools and CGM systems in improving outcomes for older adults with limited technological literacy? |
| – What strategies can enhance the accessibility and usability of these technologies for frail populations? | |
| Nutrition and frailty | – What are the most effective nutritional interventions to prevent sarcopenia and frailty progression in older adults with diabetes? |
| – How does weight loss induced by metformin, SGLT2 inhibitors, GLP-1 receptor agonists or dual agonists affect body composition, especially muscle mass? | |
| Preventive strategies | – What is the role of early frailty screening in improving diabetes outcomes in older adults? |
| – How can preventive care programs be optimized for those with multimorbidity and limited mobility? | |
| – What is the role of vaccinations in preventing not only infectious diseases but also their downstream effects on the progression of diabetes complications? | |
| Psychosocial and caregiver involvement | – How do social determinants of health impact diabetes outcomes in older adults, particularly those who are frail or cognitively impaired? |
| – What role can caregivers play in supporting diabetes management, and how can their involvement be optimized? | |
| Healthcare systems and integration | – How can healthcare systems better integrate comprehensive geriatric assessment and interdisciplinary care for older adults with diabetes and frailty? |
| – What cost-effective models of care can address the needs of aging populations with diabetes, especially in underserved areas? |
SGLT2 sodium-glucose cotransporter-2 inhibitors, GLP-1 glucagon-like peptide-1, HbA1c hemoglobin A1c, AI artificial intelligence, CGM continuous glucose monitoring