PMID- 24518176
OWN - NLM
STAT- MEDLINE
DCOM- 20160805
LR  - 20210204
IS  - 1530-891X (Print)
IS  - 1530-891X (Linking)
VI  - 20
IP  - 7
DP  - 2014 Jul
TI  - Treatment of type 2 diabetes mellitus in the older adult: a review.
PG  - 722-36
LID - 10.4158/EP13192.RA [doi]
AB  - OBJECTIVE: This review summarizes the particular challenges of diabetes in older 
      individuals and the evidence base guiding the selection of treatment targets and 
      strategies in this population. METHODS: An in-depth literature search was 
      conducted to identify the evidence base from randomized, controlled, and 
      population-based epidemiological studies, as well as guidelines derived from 
      expert opinion. RESULTS: Older patients are a highly heterogeneous population 
      with respect to the pathogenesis and course of diabetes and, as a group, manifest 
      significant comorbidities that impact treatment goals and strategies. There is a 
      lack of consensus regarding "optimal" glucose targets in older patients with 
      diabetes. Hypoglycemia is more common in the older patient, contributes to 
      increased morbidity and reduced quality of life, and limits treatment in many 
      cases. Duration of diabetes, comorbidities, life expectancy, and functional 
      status are other important factors to consider when identifying appropriate 
      glycemic goals and choosing an antihyperglycemic agent for older patients with 
      type 2 diabetes mellitus (T2DM). CONCLUSION: Current, limited treatment 
      recommendations in older patients with T2DM are based on expert opinion due to 
      the general lack of evidence from randomized controlled trials. This underscores 
      the importance of individualizing pharmacologic therapy in these patients with a 
      focus on the risk-to-benefit ratio. Additional trials in older patients are 
      needed to assess drug safety, efficacy, and dosing.
FAU - Pratley, Richard E
AU  - Pratley RE
AD  - Florida Hospital Diabetes and Translational Research Institutes, Sanford Burnham 
      Medical Research Institute, Orlando, Florida.
FAU - Heller, Simon R
AU  - Heller SR
AD  - Sheffield Teaching Hospitals Foundation Trust, University of Sheffield, 
      Sheffield, United Kingdom.
FAU - Miller, Mary Alice
AU  - Miller MA
AD  - Eli Lilly and Company, Indianapolis, Indiana.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United States
TA  - Endocr Pract
JT  - Endocrine practice : official journal of the American College of Endocrinology 
      and the American Association of Clinical Endocrinologists
JID - 9607439
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
MH  - Aged
MH  - Blood Glucose/analysis
MH  - Diabetes Mellitus, Type 2/blood/*drug therapy
MH  - Humans
MH  - Hypoglycemic Agents/therapeutic use
MH  - Life Style
EDAT- 2014/02/13 06:00
MHDA- 2016/08/06 06:00
CRDT- 2014/02/13 06:00
PHST- 2014/02/13 06:00 [entrez]
PHST- 2014/02/13 06:00 [pubmed]
PHST- 2016/08/06 06:00 [medline]
AID - S1530-891X(20)42194-9 [pii]
AID - 10.4158/EP13192.RA [doi]
PST - ppublish
SO  - Endocr Pract. 2014 Jul;20(7):722-36. doi: 10.4158/EP13192.RA.