International Journal of Clinical Practice
Author:
Keywords:
Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, Pharmacology & Pharmacy, General & Internal Medicine, GLUCAGON-LIKE PEPTIDE-1, COUNTERREGULATORY HORMONE RESPONSES, IMPROVES GLYCEMIC CONTROL, LOWERS BODY-WEIGHT, BETA-CELL FUNCTION, DIPEPTIDYL PEPTIDASE-4, EXENATIDE EXENDIN-4, CARDIOVASCULAR-DISEASE, METABOLIC ALTERATIONS, SERIOUS HYPOGLYCEMIA, Aged, Diabetes Complications, Diabetes Mellitus, Type 2, Dipeptidyl-Peptidase IV Inhibitors, Humans, Hypoglycemia, Hypoglycemic Agents, Incretins, Middle Aged, 1103 Clinical Sciences, 1117 Public Health and Health Services, 1701 Psychology, General Clinical Medicine, 3202 Clinical sciences
Abstract:
Management of elderly patients with type II diabetes is complicated by age-related changes in physiology, comorbidities, polypharmacy and heterogeneity of functional status. A minimum goal in antidiabetic treatment in this population is to achieve a level of glycaemic control that avoids acute complications of diabetes, adverse effects and reduction in quality of life. Hypoglycaemia is a particular problem in elderly patients, and many antidiabetic agents pose increased risk for hypoglycaemia. In addition, many standard agents pose risks for older patients because of reduced renal function and common comorbidities. Newer agents based on enhancing incretin activity, including the glucagon-like peptide-1 mimetics exenatide and liraglutide and the oral dipeptidyl peptidase-4 inhibitors sitagliptin and vildagliptin, may offer particular advantages in elderly patients with diabetes.