Pharmacological treatment of diabetes in the elderly

Autores: García Lara Juan Miguel Antonio, Ávila Funes José Alberto, Aguilar Navarro Sara G

Resumen

Diabetes mellitus (DM) is a high prevalence disease in the geriatric population. The elderly are at increased risk for adverse drug reactions (hypoglycemia) compared with the young, due to physiological changes associated with age, a high number of associated comorbidities and multiple drug use that lead to changes in drugs pharmacokinetics and pharmacodynamics. At present, there is a broad range of therapeutic options to treat DM, so it is suggested to become familiar with the different drug families and their potential side effects. As a general principle, metformin remains an appropriate option for the management of DM in the elderly whereas first-generation sulfonylureas such as chlorpropamide are preferably not recommended due the high risk of hypoglycemia. Some thiazolidinediones have been associated with heart failure, so their use in the elderly is controversial. New drugs that act on the DPP-4, show promising results and have a low risk of adverse reactions. We must consider the use of insulin or insulin analogues in the elderly when adequate control is not achieved with oral hypoglycemic agents. Upon therapy initiation, it is important to establish the most appropriate management goals based on patient comorbidities and life expectancy.

Palabras clave: Diabetes mellitus. Elderly. Pharmacological Treatment. Recommendations. Hypoglycemic drugs.

2013-07-25   |   514 visitas   |   Evalua este artículo 0 valoraciones

Vol. 62 Núm.4. Julio-Agosto 2010 Pags. 357-365 Rev Invest Clin 2010; 62(4-ENGLISH)