Impact of frailty metabolic phenotypes on the management of older people with type 2 diabetes mellitus
Ahmed H. Abdelhafiz, Demelza Emmerton, Alan J. Sinclair
Abstract
AIMS: To provide a pathophysiological basis for distinguishing metabolic variants of the frailty phenotype in older adults with type 2 diabetes. METHODS: We have made an in-depth review of the possible mechanisms in diabetes, ageing and frailty that will alter allow us to describe phenotypic changes which might assist in predicting responses to particular glucose-lowering therapy. RESULTS: Our review has enable us to describe with some confidence a sarcopenic obese phenotype and an anorexic malnourished phenotype. CONCLUSIONS: By identifying these two phenotypes we can predict which would be most responsive to certain classes of therapy and where therapies may be ill-advised. This represents the first novel approach in this area. Further work is being planned to develop this hypothesis. Geriatr Gerontol Int 2021; 21: 614-622.