Use of antidiabetic drugs in elderly patients

The objective of this review of the literature is to analyze the results of studies including diabetic patients aged 70 years and older. Although the risk of treatment is greater in this population because of co-morbid conditions and altered renal function, information on the pharmacokinetics and pharmacodynamics of antidiabetic drugs remains limited. Long-term experience with sulfonylureas is sufficient to establish certain general rules of use; but for biguanides and alpha-glucosidase inhibitors, problems of tolerance limit use; further data are needed on glinides and glitazones. Use of insulin or insulin analogs is frequent and prescription should be adapted to achieve an acceptable balance between the risk of hypoglycaemia and therapeutic goals.