The efficacy and safety of semaglutide vs comparators in non‐elderly (<65 years) and elderly (≥65 years) patients with type 2 diabetes (T2D) across the SUSTAIN 1‐5 trials were evaluated. Patients were randomized to once‐weekly subcutaneous semaglutide (0.5 or 1.0 mg) vs placebo, sitagliptin, exenatide or insulin. The primary objective was change in HbA1c and secondary objectives were changes in body weight and safety. Mean HbA1c decreased from baseline by 1.2%‐1.5% and 1.5%‐1.9% vs 0%‐0.9% (non‐elderly, n = 3045) and by 1.3%‐1.5% and 1.2%‐1.8% vs 0.2%‐1.0% (elderly, n = 854) with semaglutide 0.5 and 1.0 mg vs comparators. Similar reductions from baseline in mean body weight with semaglutide occurred in both age groups. Similar proportions of patients experienced adverse events; premature treatment discontinuations were higher in elderly vs non‐elderly patients. No increased risk of severe or blood glucose‐confirmed hypoglycaemia was seen with semaglutide vs comparators between age groups. Semaglutide had a comparable efficacy and safety profile in non‐elderly and elderly patients across the SUSTAIN 1‐5 trials, making it an effective treatment option for elderly patients with T2D.

Patients were very willing to share medical information with their providers. They were able to see the importance of sharing medical information to provide the best possible care. They were unwilling to hide information from providers if there was increased medical risk. Patients were willing to spend additional time for privacy, but most were unwilling to spend extra money. Sixty-eight percent of patients favored reducing medical costs over privacy.

It is important to remember the basics when treating patients with diabetes. Follow current diagnostic criteria, and clearly communicate findings to patients. Set target glucose levels, and encourage patients to take an active role in controlling their disease. Set time limits for therapy effectiveness, and use combination therapy with caution. Recommend use of home glucose monitors and regular monitoring of glucose levels throughout the day. For more flexibility, adapt insulin dosages to patient needs and use basal insulin, rather than sliding-scale insulin. Finally, remember that early detection and intervention can delay or even prevent complications.

Preview Many people know the "tight-hatband" feeling that can occur at the end of an anxiety-filled day. An over-the-counter analgesic and a good night's sleep usually take care of it. But sometimes, headaches recur often or last days, and stronger measures are required. Dr Trachtenbarg summarizes the criteria for diagnosing tension headaches and outlines a stepwise approach to use of analgesic and prophylactic medications that minimizes the potential for dependence.

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