Abstract
Elderly patients with type 2 diabetes mellitus (T2DM) are a rapidly emerging population that presents unique clinical challenges. This diverse patient group can differ widely in terms of physical and mental status, which can increase their risk of complications including hypoglycemia, falls, and depression. These factors can negatively impact their glycemic control, safety, and quality of life. The risk of hypoglycemic events is elevated among elderly patients with diabetes. In many cases, these events are related to antidiabetic therapy and the pursuit of strict glycemic control. Fear of a hypoglycemic episode, on the part of the patient and/or healthcare provider, is another major barrier to achieving glycemic control. Hypoglycemic events, even in the absence of awareness of the event (asymptomatic), can have negative consequences. To help manage these risks, several national and international organizations have proposed guidelines to address individualized treatment goals for older adults with diabetes. This article reviews current treatment guidelines for setting glycemic targets in elderly patients with T2DM, and discusses the role of emerging treatment options in this patient population.
Highlights
Among persons aged 65 years and older living in the United States, the estimated prevalence of diabetes mellitus ranges from 22% to 33% [1]
65 years and older living in the United States will be diagnosed with diabetes [2, 3]
Hypoglycemic events occurred predominantly in patients receiving concomitant insulin and/ or sulfonylurea therapy. These findings suggest that adjunctive linagliptin is effective in elderly patients with inadequately controlled Type 2 diabetes mellitus (T2DM) and does not impose an excess risk of hypoglycemia
Summary
Among persons aged 65 years and older living in the United States, the estimated prevalence of diabetes mellitus ranges from 22% to 33% [1]. 65 years and older living in the United States will be diagnosed with diabetes [2, 3]. As with younger adults, achieving and maintaining glycemic control is important in elderly patients with T2DM to prevent acute complications of hyperglycemia and reduce the risk of long-term complications [5, 6]. Some elderly patients will be able to maintain glycemic control with lifestyle modification and oral antidiabetic drugs (OADs), most will eventually require insulin because of the progression of T2DM [7,8,9]
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