Nearly half of all type 2 diabetes cases in the United States are among individuals aged 65 years or older. Management of diabetes in this population requires special considerations. This article reviews the pharmacologic management of type 2 diabetes with these considerations in mind. Increasing life expectancies have underscored the importance of preventing long-term diabetes complications within the overall management strategy for elderly diabetic patients. Aggressive glycemic control is central to preventing such complications and may prove cost-effective. To maintain glycemic control, patients usually progress from initial dietary therapy to one and then two or more oral hypoglycemic medications in a stepwise fashion. Adjunctive insulin is eventually often required as well. The initial oral agent is usually either a sulfonylurea or metformin, although meal schedules and the risk of postprandial hyperglycemia may necessitate other choices. Avoiding hypoglycemia is of particular concern in the elderly, whereas the need for weight loss is usually of less concern. Above all, treatment of the elderly patient must be individualized for optimal care.
|Original language||English (US)|
|Number of pages||15|
|State||Published - Jul 1 2000|
ASJC Scopus subject areas
- Pharmacology (medical)