Impact of frailty metabolic phenotypes on the management of older people with type 2 diabetes mellitus.

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.