OBJECTIVE: Discuss
geriatric considerations in the treatment of
diabetes mellitus and review the advantages and disadvantages of the various
pharmacologic agents, including oral
medications and
insulin, currently available for the treatment of
type 2 diabetes mellitus (
T2DM). DATA SOURCES: Literature identified within
MEDLINE and PubMED, with an emphasis on material published since 2000, were reviewed. STUDY SELECTION: Overall, 67 primary study manuscripts, clinical reviews, and
dosing guidelines were identified and reviewed based on their clinical relevance to the
geriatric population. DATA EXTRACTION: Literature searches were performed for studies and reviews that included information on the use of
antidiabetic medications in the
geriatric population. Information was gathered from the available literature base for each
medication class included in the review. DATA SYNTHESIS: The literature identified provided guidelines and considerations for the treatment of the older patient with
diabetes mellitus to optimize patient outcomes while minimizing the risk for
adverse events. This review provides a systematic outline of these considerations and suggests treatment
pearls. CONCLUSION: The approach to managing
T2DM in the
elderly should be conservative and methodical in nature, with careful consideration of side effects, drug-disease and
drug-drug interactions, and the risk of inducing
hypoglycemia in this at-risk population.
