Pros and cons of polypharmacy in elderly patients with diabetes

Abstract

According to the World Health Organization (WHO), polypharmacy is a safe and effective treatment with at least five drugs that is consistent with evidencebased medicine. Unfortunately, too often combination therapies are used without scientific justification. Contemporary available spectrum of hypoglycaemic drugs enables the use of a variety of combinations. Two or, less often, three drugs with different mechanisms of action are used simultaneously. Taking into account the fact that patients with T2DM are likely to have other diseases that require multiple medications, the potential risk of clinically relevant drug interactions is high. This may, inter alia, undesirably affect the daily fluctuations of glycaemia with the serious consequences of this phenomenon. The risk of severe hypoglycaemia or hyperglycaemia is especially related to elderly patients. In this group polypragmasy is much more common than in the same age group with normal carbohydrate metabolism. The aim of this paper is to discuss the phenomenon of polypragmasy with particular emphasis on its occurrence in elderly patients with T2DM.