Management of Type 2 Diabetes in the Geriatric Patient

Campbell, Suzanne

doi:10.1177/089719000001300404

Cited by 1 publication

(2 citation statements)

References 58 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The release of insulin is glucose dependent and diminishes at lower glucose concentrations so the administration of these agents must be with meals. 14 The currently available meglitinides include nateglinide and repaglinide. Although the meglitinides are not considered first-line agents for type 2 diabetes, they may offer an alternative to the sulfonylureas in those who have history of sulfonamide allergy, who have postprandial hyperglycemia, or who are at high risk for hypoglycemia because of erratic meals.…”

Section: Meglitinidesmentioning

confidence: 99%

See 1 more Smart Citation

Screening, Diagnosis, and Pharmacotherapy for Type 2 Diabetes Mellitus

Levy¹,

Cohen²

2003

Journal of Pharmacy Practice

View full text Add to dashboard Cite

Type 2 diabetes is increasing in prevalence. It is pragmatic to screen patients for diagnostic testing. Diet, exercise, and oral therapy remain the primary treatment modalities for type 2 diabetes. First generation sulfonylureas have fallen out of favor due to adverse effects. Second generation sulfonylureas, metformin, or their combinations are recommended firstline. Glipizide and glimepiride are preferred in elderly, hepatically, and renally impaired patients. Metformin is not recommended with chronic heart failure, renal insufficiency, and in the elderly due to lactic acidosis risks. Glitazones are for second-line therapy, should be used cautiously with cardiac insufficiencies, and require routine monitoring of liver enzymes. Meglitinides, not first-line, may offer an alternative to sulfonylureas. Alpha-glucosidase inhibitors, most effective with impaired glucose tolerance, may be combined with sulfonylureas or metformin. Pharmacists play an integral role in management and pharmacotherapy services in diabetes may be implemented in collaborative drug therapy monitoring for maximizing cost effectiveness.B Y THEIR LITERAL DEFINITIONS, diabetes is a condition characterized by polyuria, and mellitus means sweetened with honey. 1 Clinically, diabetes mellitus is a chronic condition that results in devastating and deleterious consequences, especially when uncontrolled in the long term. The prevalence of type 2 diabetes mellitus, formerly known as non-insulindependent diabetes or adult-onset diabetes, is increasing among adults from 7.4% in 1995 to projections of 9% by 2025. 2 The increasing prevalence of type 2 diabetes may be due to the growing elderly and obese populations, increasing public awareness of the disease, and increased screening through education. 2 In 1997, direct and indirect costs of both type 1 and type 2 diabetes mellitus were estimated to be $98 billion. 3 Interestingly, the cost for treating both types of diabetes accounted for 17% of the total cost, whereas treating chronic complications and its medical conditions accounted for 83%. 3 Screening patients by recognizing and evaluating risk factors for diabetes is necessary to identify persons who require blood glucose testing in order to diagnose diabetes. 2 The results of large randomized trials in diabetic subjects who did not have serious microvascular complications demonstrated significant benefits from tight glycemic control, such as decreased retinopathy and neuropathy. 4 However, benefits of tight blood glucose control in the elderly older than the age of 65 years and those who already had advanced complications have not been demonstrated because clinical trials in these settings have not been conducted. 3 Therefore, it is of paramount importance to identify patients at risk for diabetes through blood glucose testing, subsequently

show abstract

Section: Meglitinidesmentioning

confidence: 99%

“…Although the meglitinides are not considered first-line agents for type 2 diabetes, they may offer an alternative to the sulfonylureas in those who have history of sulfonamide allergy, who have postprandial hyperglycemia, or who are at high risk for hypoglycemia because of erratic meals. 14…”

Section: Meglitinidesmentioning

confidence: 99%

Screening, Diagnosis, and Pharmacotherapy for Type 2 Diabetes Mellitus

Levy¹,

Cohen²

2003

Journal of Pharmacy Practice

View full text Add to dashboard Cite

show abstract

Management of Type 2 Diabetes in the Geriatric Patient

Cited by 1 publication

References 58 publications

Screening, Diagnosis, and Pharmacotherapy for Type 2 Diabetes Mellitus

Screening, Diagnosis, and Pharmacotherapy for Type 2 Diabetes Mellitus

Contact Info

Product

Resources

About