ISSN : 1302-7123 | E-ISSN : 1308-5123

Hızlı Arama




Approach to the treatment of diabetes in the elderly [SETB]
SETB. Baskıdaki Makaleler: SETB-00868 | DOI: 10.14744/SEMB.2019.00868

Approach to the treatment of diabetes in the elderly

Yüksel Altuntaş
University of Health Sciences,Şişli Hamidiye Etfal Teaching and Resarch Hospital, Endocrinology and metabolism Clinic.

Other concomitant diseases of elderly people with diabetes (renal failure, heart failure, ischemic heart disease, stroke, urinary incontinence, cognitive impairment, dementia, sarcopenia, osteoporosis) make diabetes management difficult. Therefore, a treatment approach should be presented in elderly diabetics to consider other comorbid conditions or comorbid conditions. The use of oral antidiabetics over the age of 75 may be limited by their use. Although the diabetes treatment approach does not differ in the healthy elderly, hypoglycemia is one of the most feared conditions especially in the elderly. Therefore, metformin, DPP-IV inhibitors, SGLT2 inhibitors should be considered in the first place with less risk of hypoglycemia. Low-dose sulfonylureas may also be used in selected cases. The use of new antidiabetic drugs, such as GLP-1 anologues and SGLT2 inhibitors, has strengthened our ability to cope with the risk of hypoglycemia and cardiovascular events, which are the two most important drawbacks in the treatment of elderly people with diabetes. Insulin treatment should be individualized and the most rare injection regimens should be used. In case of failure with OAD, basal insulin should be added to the current treatment and, if necessary, a basal + plus regimen should be planned by adding bolus insulin 1-2-3 times per day to meals. As a result, in elderly diabetics, inadequate treatment or excessive treatment and individualizing the treatment should be the most appropriate approach.

Anahtar Kelimeler: Diabetes, elderly, Antidiabetic therapy

Approach to the treatment of diabetes in the elderly

Yüksel Altuntaş
University of Health Sciences,Şişli Hamidiye Etfal Teaching and Resarch Hospital, Endocrinology and metabolism Clinic.

Other concomitant diseases of elderly people with diabetes (renal failure, heart failure, ischemic heart disease, stroke, urinary incontinence, cognitive impairment, dementia, sarcopenia, osteoporosis) make diabetes management difficult. Therefore, a treatment approach should be presented in elderly diabetics to consider other comorbid conditions or comorbid conditions. The use of oral antidiabetics over the age of 75 may be limited by their use. Although the diabetes treatment approach does not differ in the healthy elderly, hypoglycemia is one of the most feared conditions especially in the elderly. Therefore, metformin, DPP-IV inhibitors, SGLT2 inhibitors should be considered in the first place with less risk of hypoglycemia. Low-dose sulfonylureas may also be used in selected cases. The use of new antidiabetic drugs, such as GLP-1 anologues and SGLT2 inhibitors, has strengthened our ability to cope with the risk of hypoglycemia and cardiovascular events, which are the two most important drawbacks in the treatment of elderly people with diabetes. Insulin treatment should be individualized and the most rare injection regimens should be used. In case of failure with OAD, basal insulin should be added to the current treatment and, if necessary, a basal + plus regimen should be planned by adding bolus insulin 1-2-3 times per day to meals. As a result, in elderly diabetics, inadequate treatment or excessive treatment and individualizing the treatment should be the most appropriate approach.

Keywords: Diabetes, elderly, Antidiabetic therapy



Sorumlu Yazar: Yüksel Altuntaş
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