Glycemic targets and medication limitations for type 2 diabetes mellitus in the older adult.

Autor: Thompson AM; University of Wyoming School of Pharmacy, Laramie, Wyoming., Linnebur SA; Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado., Vande Griend JP; Departments of Clinical Pharmacy and Family Medicine, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences., Saseen JJ; Departments of Clinical Pharmacy and Family Medicine, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences.
Jazyk: angličtina
Zdroj: The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists [Consult Pharm] 2014 Feb; Vol. 29 (2), pp. 110-23.
DOI: 10.4140/TCP.n.2014.110
Abstrakt: Objective: To review the optimal management of type 2 diabetes mellitus (T2DM) in the older adult.
Data Sources: A PubMed search was completed to identify publications in the English language from 1947 to 2013 using combinations of the search terms: geriatrics, aged, diabetes mellitus, and type 2 diabetes mellitus. References of articles were also reviewed for inclusion if not identified in the PubMed search.
Study Selection and Data Extraction: Original studies, clinical reviews, and guidelines were identified and evaluated for clinical relevance.
Data Synthesis: Although the number of older adults with T2DM is growing, evidence for the treatment of T2DM in this population is lacking. Barriers such as polypharmacy, comorbid conditions, economic limitations, cognitive impairment, and increased risk of hypoglycemia may limit optimal glycemic control in older adults. Several organizations provide recommendations for glycemic targets and recommend using standard glycemic goals in most healthy older adults. However, less stringent goals are necessary in certain older populations such as those patients with limited life expectancy and severe hypoglycemia. In general, glycemic goals should be individualized in older patients. Age-related pharmacokinetic and pharmacodynamic changes, comorbid conditions, adverse drug reactions, ease of medication administration, and cost of medications necessitate the need to individualize pharmacologic therapy.
Conclusion: Glycemic targets and medication use for T2DM should be individualized in older adults.
Databáze: MEDLINE