Diabetes is very common among the elderly. In Italy, more than 20% of people older than 75 suffer from the disease. Many of them are frail, with extensive comorbid conditions, or long-standing diabetes in whom the risk of hypoglycemia is very high. An appropriate multidimensional approach is therefore needed when assessing geriatric syndromes, including frailty, cognitive impairment, poor mobility, reduced vision and hearing, depression, and chronic pain. Although in the last few years the benefits of intensive glucose treatment have been described, it is becoming increasingly clear that over-treatment, particularly in older adults, is a significant problem given the fact that hypoglycemia is related to a number of adverse conditions, including mortality. Consequently, and in the light of a “patient-centered approach”, less stringent A1c goals (such as <8.0-8.5%) may be appropriate for these patients. The risk of hypoglycemia is highest with insulin and sulphonyl - ureas, mainly glibenclamide. These latter drugs should be avoid in older diabetics. New hypoglycemic agents with a very low risk of hypoglycemia have recently been introduced on the market. This review assesses these drugs and insulin analogs.
|Translated title of the contribution||Hypoglycemia in the frail elderly diabetic patient|
|Number of pages||8|
|Journal||Giornale Italiano di Diabetologia e Metabolismo|
|Publication status||Published - Sep 1 2015|
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism