Abstract

Diabetes is a chronic incurable disease of high prevalence in older people due to changes in glucose homeostasis, diabetes-related complications and other comorbidities that affect physical and cognitive functioning and have implications for medicines use. Polypharmacy is common and represents a significant medicine and selfcare burden, risk of medicine-related adverse events, and inappropriate prescribing. Some medicines used to treat diabetes such as insulin, sulphonylureas, warfarin and antiplatelet agents are known as ‘high risk’ medicines because of their association with adverse events. Managing medicines is a complex process that requires particular knowledge and skills and strategies to proactively identify risks and plan care to reduce the risk such as following evidence based recommendations/ guidelines, comprehensive assessment and monitoring, using decision support tools such as BEERs, STOPP and START criteria, and importantly, involving the individual and/or carers in medicine decisions to personalise medicines education and the medicine regimen.

Highlights

  • : Older people; Diabetes; Glucose Pharmacovilance; Quality use of medicines lowering medicines; Introduction and Background to Diabetes

  • Insulin resistance and elevated postprandial blood glucose are features of overweight older people with T2DM [2]. These people might benefit from Metformin and/or other glucose lowering medicines (GLM) but most eventually require insulin [3]

  • Reduced appetite due to age and some medicines increase the risk of hypoglycaemia and further reduce the already compromised ability to mount a counter-regulatory response to hypoglycaemia

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Summary

Open Access

Glucose Lowering Medicines and Older People with Diabetes: The Importance of Comprehensive Assessments and Pharmacovigilance. Received date: February 21, 2014; Accepted date: May 3, 2014; Published date: May 7, 2014

The Imperative for Pharmacovigilance
Possible consequences
Urine glucose testing is not appropriate to detect hypoglycaemia
Associated risk
Some blunt myocardial preconditioning
Fractures in the extremities especially in women
Flatulence Gastrointestinal disturbances
Insulin Short Rapid Long acting analogues Premixed
Sliding insulin scales to manage hyperglycaemia is contraindicated
Findings
Conclusion

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