PMID- 34859336
OWN - NLM
STAT- MEDLINE
DCOM- 20230501
LR  - 20230502
IS  - 1573-7322 (Electronic)
IS  - 1382-4147 (Linking)
VI  - 28
IP  - 3
DP  - 2023 May
TI  - Pharmacological treatment of type 2 diabetes in elderly patients with heart 
      failure: randomized trials and beyond.
PG  - 667-681
LID - 10.1007/s10741-021-10182-x [doi]
AB  - Heart failure (HF) and type 2 diabetes mellitus (T2DM) represent two important 
      public health problems, and despite improvements in the management of both 
      diseases, they are responsible for high rates of hospitalizations and mortality. 
      T2DM accelerates physiological cardiac aging through hyperglycemia and 
      hyperinsulinemia. Thus, HF and T2DM are chronic diseases widely represented in 
      elderly people who often are affected by numerous comorbidities with important 
      functional limitations making it difficult to apply the current guidelines. 
      Several antidiabetic drugs should be used with caution in elderly individuals 
      with T2DM. For instance, sulfonylureas should be avoided due to the risk of 
      hypoglycemia associated with its use. Insulin should be used with caution because 
      it is associated with higher risk of hypoglycemia, and may determine fluid 
      retention which can lead to worsening of HF. Thiazolindinediones should be 
      avoided due to the increased risk of fluid retention and HF. Biguanides may lead 
      to a slightly increased risk of lactic acidosis in particular in elderly 
      individuals with impaired renal function. Dipeptidyl peptidase 4 (DPP-4) 
      inhibitors are safe having few side effects, minimal risk of hypoglycemia, and a 
      neutral effect on cardiovascular (CV) outcome, even if it has been reported that 
      saxagliptin treatment is associated with increased risk of hospitalizations for 
      HF (hHF). Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown a CV 
      protection without a significant reduction in hHF. On the other hand, 
      sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown a significant 
      improvement in CV outcome, with a strong reduction of hHF and a positive impact 
      on renal damage progression. However, it is necessary to consider the possible 
      some side effects related to their use in elderly individuals including 
      hypotension, bone fractures, and ketoacidosis.It is important to remark that 
      elderly patients, in particular the very elderly, are not sufficiently 
      represented in the trials; thus, the management and treatment of elderly diabetic 
      patients with HF should be mainly based on the integration of scientific evidence 
      with clinical judgment and patients' condition, with respect to the dignity and 
      quality of life.
CI  - (c) 2021. The Author(s), under exclusive licence to Springer Science+Business 
      Media, LLC, part of Springer Nature.
FAU - Sciacqua, Angela
AU  - Sciacqua A
AD  - Department of Medical and Surgical Sciences, University Magna Graecia of 
      Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, 
      Italy. sciacqua@unicz.it.
FAU - Succurro, Elena
AU  - Succurro E
AD  - Department of Medical and Surgical Sciences, University Magna Graecia of 
      Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, 
      Italy.
FAU - Armentaro, Giuseppe
AU  - Armentaro G
AD  - Department of Medical and Surgical Sciences, University Magna Graecia of 
      Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, 
      Italy.
FAU - Miceli, Sofia
AU  - Miceli S
AD  - Department of Medical and Surgical Sciences, University Magna Graecia of 
      Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100, Catanzaro, 
      Italy.
FAU - Pastori, Daniele
AU  - Pastori D
AD  - Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, 
      Sapienza University of Rome, Rome, Italy.
FAU - Rengo, Giuseppe
AU  - Rengo G
AD  - Department of Translational Medical Sciences, University of Naples "Federico II", 
      Naples, Italy.
AD  - Istituti Clinici Scientifici (ICS) Maugeri SPA, Societa Benefit, IRCCS, Pavia, 
      Italy.
AD  - Istituto Scientifico di Telese Terme, Telese, Terme, Italy.
FAU - Sesti, Giorgio
AU  - Sesti G
AD  - Department of Clinical and Molecular Medicine, University Rome-Sapienza, Rome, 
      Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20211202
PL  - United States
TA  - Heart Fail Rev
JT  - Heart failure reviews
JID - 9612481
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
SB  - IM
MH  - Humans
MH  - Aged
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy
MH  - Quality of Life
MH  - Randomized Controlled Trials as Topic
MH  - *Heart Failure/complications/drug therapy
MH  - *Dipeptidyl-Peptidase IV Inhibitors/therapeutic use
MH  - *Hypoglycemia
MH  - *Cardiovascular Diseases/drug therapy
OTO - NOTNLM
OT  - Antidiabetic drugs
OT  - Elderly
OT  - Frailty
OT  - Heart failure
OT  - Type 2 diabetes mellitus
EDAT- 2021/12/04 06:00
MHDA- 2023/05/01 06:41
CRDT- 2021/12/03 07:16
PHST- 2021/10/14 00:00 [accepted]
PHST- 2023/05/01 06:41 [medline]
PHST- 2021/12/04 06:00 [pubmed]
PHST- 2021/12/03 07:16 [entrez]
AID - 10.1007/s10741-021-10182-x [pii]
AID - 10.1007/s10741-021-10182-x [doi]
PST - ppublish
SO  - Heart Fail Rev. 2023 May;28(3):667-681. doi: 10.1007/s10741-021-10182-x. Epub 
      2021 Dec 2.