Advances in diabetes therapy in the elderly

Abstract

Diabetes is increasing in prevalence and the choice of medication is expanding with the recent introduction of a new class of oral hypoglycaemics. Emerging data on the older oral hypoglycaemics is adding to the complexity of diabetes management, particularly in the elderly for whom special consideration of adverse effects and dosing are required. As diabetes progresses the inevitable decline in pancreatic β-cell function diminishes the efficacy of the oral hypoglycaemics and insulin is required. The new synthetic long-acting insulin analogues are useful in the elderly both for ease of administration and to minimise hypoglycaemia. Exogenous insulin often does not provide optimal control of diabetes and it is envisioned that in the future, therapy may target preservation of pancreatic β-cell function to produce long-term glycaemic control with endogenous insulin.