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Cardiac risk factors and hypoglycemia in an elderly patient: how good is good enough?

Curtis Triplitt1

  • 1Texas Diabetes Institute, San Antonio, Texas 78207, USA. curtis.triplitt@uhs-sa.com

The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists
|August 24, 2010
PubMed

Insights

Early glycemic control benefits elderly patients with type 2 diabetes mellitus (T2DM) if achieved safely. Individualized treatment plans are crucial to balance A1C goals and hypoglycemia risks.

Area of Science:

  • Geriatric Medicine
  • Endocrinology
  • Pharmacology

Background:

  • Type 2 diabetes mellitus (T2DM) management in elderly patients presents unique challenges.
  • Glycosylated hemoglobin (A1C) targets, cardiovascular disease (CVD) risk, and hypoglycemia are key considerations.

Observation:

  • Trials like ADVANCE, VADT, and ACCORD show mixed results on A1C reduction and CVD risk.
  • Long-term UKPDS data suggest early glycemic control can reduce future CVD risk.
  • Intensive glycemic control in the elderly may increase the risk of severe hypoglycemia.

Findings:

  • Lowering A1C did not consistently reduce CVD risk in major trials.
  • Early, safe glycemic control appears beneficial for long-term outcomes in T2DM.
  • Hypoglycemia poses a significant risk in older adults with T2DM.

Implications:

  • Treatment goals for elderly T2DM patients require individualization.
  • Pharmacists must carefully manage A1C targets to avoid hypoglycemia.
  • Balancing glycemic control and safety is paramount for this population.
Abstract

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