Usually, older patients are defined as those aged ≥65 years (WHO definition of ≥65 years). Older patients with type 1 diabetes are characterized by older age and poorer physical function, and treatment differs little from that of the general population; more important is avoidance of hypoglycemia and related complications and more attentive family care.
Multiple daily insulin injections (see table below) and insulin pump regimens are the mainstay (see table 1). Combination of oral metformin and acarbose may be considered in some patients, but needs to be determined by the treating physician after adequate evaluation.
Table 1 Multiple Daily Insulin Injection Regimens for Type 1 Diabetes
It is important to note that older patients have inherent osteoporosis and are more likely to develop osteopenia if their blood glucose is not well controlled, so during treatment, it is also recommended to review bone density once a year, in addition to the general program.