What is your approach to the use of GLP-1 agonists in older adults with diabetes with or at risk of sarcopenia?

This is an important question to keep an eye on, given the broadening use and effectiveness of GLP-1 agonists for various conditions, especially diabetes, and for weight loss. Unfortunately, as is so often the case, major clinical trials in this area do not reflect the heterogeneity of older adults ...

As in the management of any other medical condition, treatment with GLP-1 RA or dual receptor agonists, the treatment should be individualized. I agree with Dr. @Dr. First Last that treatment with GLP-1 RAs should be avoided in the very elderly (80+), particularly those with cognitive impairment. Ho...

I tried to avoid GLP-1 agonists in older adults, especially if they have a cognitive impairment, and they are monitored on their daily basis can be challenging.

In one patient in her 80s, I reduced the dose when it was quickly increased, and she started having dizziness. She has lost weight, which ha...

I have only used GLP-1 agonists in older adults with diabetes who also want to lose weight and are otherwise robust. IE, pretty few. There is good evidence for the risk of sarcopenia with GLP-1 agonists, so I am usually reluctant to use them for this patient population. I feel there are better optio...

Since GLP-1 has multiple benefits, it may be reasonable to discuss potential benefits and risks, shared decision making, and prescribe and monitor closely.