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Related Concept Videos

Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

698
Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
698
Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

157
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
157
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

131
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
131
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

120
Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
120
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

172
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
172
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

486
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
486

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Hypoglycemia in Older Patients.

Byron J Hoogwerf1

  • 1Cleveland Clinic, Cleveland, OH, USA; Central Michigan University, College of Medicine, Mount Pleasant, MI, USA.

Clinics in Geriatric Medicine
|June 27, 2020
PubMed
Summary
This summary is machine-generated.

Hypoglycemia poses significant risks for elderly individuals with diabetes. This chapter outlines key risk factors and strategies to minimize hypoglycemia, considering medication, comorbidities, and cognitive decline.

Keywords:
Diabetes mellitusElderlyHyperglycemiaHypoglycemiaOlder patients

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Area of Science:

  • Gerontology
  • Endocrinology
  • Pharmacology

Background:

  • Hypoglycemia is a critical complication in older adults managing diabetes mellitus.
  • Identifying and mitigating hypoglycemia risks is essential for patient safety and well-being.

Purpose of the Study:

  • To comprehensively review risk factors contributing to hypoglycemia in elderly diabetic patients.
  • To present evidence-based strategies for the effective mitigation of hypoglycemia risk.

Main Methods:

  • Literature review focusing on risk factors and management of hypoglycemia in older adults with diabetes.
  • Analysis of glucose-lowering agents, impact of comorbidities, and cognitive dysfunction on hypoglycemia incidence.

Main Results:

  • Older diabetic patients face elevated hypoglycemia risks due to physiological changes and polypharmacy.
  • Specific glucose-lowering agents carry differential hypoglycemia risks.
  • Comorbid conditions and cognitive impairment significantly exacerbate hypoglycemia risk.

Conclusions:

  • A multifactorial approach is necessary to manage hypoglycemia in elderly patients with diabetes.
  • Careful selection of antidiabetic medications and proactive management of comorbidities are crucial.
  • Addressing cognitive dysfunction is vital for preventing and managing hypoglycemia in this vulnerable population.