TY - JOUR
T1 - Management of diabetes in older adults
AU - Sesti, G.
AU - Antonelli Incalzi, R.
AU - Antonelli Incalzi, Raffaele
AU - Bonora, E.
AU - Consoli, A.
AU - Giaccari, Andrea
AU - Maggi, S.
AU - Paolisso, G.
AU - Purrello, F.
AU - Vendemiale, G.
AU - Ferrara, N.
PY - 2018
Y1 - 2018
N2 - Type 2 diabetes prevalence is high in older adults and is expected to rise in the next decades. Diabetes in the population of frail older adults is accompanied by functional disability, several comorbidities, and premature mortality. A comprehensive geriatric assessment, including functional, cognitive, mental and social status, is advisable for identifying the glycemic targets and glucose-lowering therapies, focused on patient preferences, needs, and risks. The therapeutic options for older adults with diabetes are like those for the adult population. However, the pharmacological treatments must be carefully prescribed and monitored, taking into consideration the patient cognitive capacities, the potentially life-threatening drug-drug interactions, the cardiovascular risk, and with the main goal of avoiding hypoglycemia. Also, a careful nutritional evaluation with appropriate tools, as well as a balanced and periodically monitored physical activity, contribute to an effective tailored care plan, as needed by older adults with diabetes. This review evaluates the currently available hypoglycemic drugs and the current indications to the Italian diabetology community, specifically with regard to the treatment of adults aged 75 years or older with diabetes, including the unmet needs by the guidelines.
AB - Type 2 diabetes prevalence is high in older adults and is expected to rise in the next decades. Diabetes in the population of frail older adults is accompanied by functional disability, several comorbidities, and premature mortality. A comprehensive geriatric assessment, including functional, cognitive, mental and social status, is advisable for identifying the glycemic targets and glucose-lowering therapies, focused on patient preferences, needs, and risks. The therapeutic options for older adults with diabetes are like those for the adult population. However, the pharmacological treatments must be carefully prescribed and monitored, taking into consideration the patient cognitive capacities, the potentially life-threatening drug-drug interactions, the cardiovascular risk, and with the main goal of avoiding hypoglycemia. Also, a careful nutritional evaluation with appropriate tools, as well as a balanced and periodically monitored physical activity, contribute to an effective tailored care plan, as needed by older adults with diabetes. This review evaluates the currently available hypoglycemic drugs and the current indications to the Italian diabetology community, specifically with regard to the treatment of adults aged 75 years or older with diabetes, including the unmet needs by the guidelines.
KW - Antidiabetic drugs
KW - Cardiology and Cardiovascular Medicine
KW - Endocrinology, Diabetes and Metabolism
KW - Hypoglycemia
KW - Medicine (miscellaneous)
KW - Nutrition and Dietetics
KW - Older adults
KW - Personalized medicine
KW - Type 2 diabetes
KW - Antidiabetic drugs
KW - Cardiology and Cardiovascular Medicine
KW - Endocrinology, Diabetes and Metabolism
KW - Hypoglycemia
KW - Medicine (miscellaneous)
KW - Nutrition and Dietetics
KW - Older adults
KW - Personalized medicine
KW - Type 2 diabetes
UR - http://hdl.handle.net/10807/116496
UR - http://www.elsevier.com/wps/find/journaldescription.cws_home/704955/description#description
U2 - 10.1016/j.numecd.2017.11.007
DO - 10.1016/j.numecd.2017.11.007
M3 - Article
SN - 0939-4753
VL - 28
SP - 206
EP - 218
JO - NMCD. NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
JF - NMCD. NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
ER -