[Individualized diabetes therapy in older persons].

Area of Science:

• Gerontology
• Endocrinology
• Pharmacology

Background:

• Older adults with type 2 diabetes often present with multiple comorbidities, frailty, and functional limitations.
• Polypharmacy is common and poses significant risks, particularly concerning antihyperglycemic agents and hypoglycemia.
• Careful risk-benefit assessment is essential when prescribing diabetes medications to elderly patients.

Purpose of the Study:

• To highlight the specific conditions and characteristics of older individuals with diabetes.
• To emphasize the importance of individualized therapy approaches for diabetes management in the elderly.
• To review current and novel therapeutic options for type 2 diabetes in older populations.

Main Methods:

• Review of current literature on type 2 diabetes management in older adults.
• Analysis of the advantages and disadvantages of various antidiabetic drug classes.
• Discussion of individualized treatment strategies considering patient-specific factors.

Main Results:

• Established oral agents like metformin and newer classes such as gliptins offer advantages for older patients.
• Novel oral agents, including gliflozin drugs, present both benefits and drawbacks.
• Injectable therapies, including glucagon-like peptide-1 (GLP-1) mimetics and modern insulins, can be valuable when used judiciously.

Conclusions:

• Individualized therapy is paramount for managing type 2 diabetes in older adults.
• A balanced approach considering efficacy, safety, and patient characteristics is necessary.
• Metformin, gliptins, gliflozins, GLP-1 mimetics, and new insulins represent a spectrum of options for tailored diabetes care in the elderly.