Management of hypoglycemic therapy in older adults: challenges and opportunities

Abstract

Diabetes is a highly prevalent disease in people over 65 years old, affecting more than 29% of this population. This group presents great heterogeneity both in functional status, in clinical characteristics and life expectancy, which poses the challenge of an individualized therapeutic design adapted to each patient. With the objective of reducing morbidity and mortality, we face with making a selection of drugs that takes into account glycemic objectives, the presence of comorbidities and frailty, access to medication, the complexity of the treatment and the patient's skills to implement it. GLP-1RA and iSGLT2, beyond the cardiovascular and renal benefit and the absence of risk of hypoglycemia, have demonstrated efficacy and safety in this group. Its incorporation into the therapeutic algorithm of older adult presents a new perspective that will require a critical medical indication.