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[老年糖尿病患者的药物治疗概述]

[Overview of drug therapy in elderly diabetic patients].

作者信息

Kigawa Yoshiaki, Suzuki Tatsuya, Oba Kenzo

机构信息

Hanno Geriatric Center.

Division of Geriatric Medicine, Nippon Medical School.

出版信息

Nihon Rinsho. 2013 Nov;71(11):1982-6.

Abstract

General treatment principles for elderly diabetic patient with type 2 diabetes are the same as those of adult care. However, hypoglycemia and other adverse effects of glucose-lowering treatment are more common in older patients. Understanding the advantages and disadvantages of each antihyperglycemic drug class helps clinicians individualize therapy for elderly patients. Especially, given the heterogeneity of the older adult population, the risk of hypoglycemia must be carefully considered before using sulfonylureas and insulin regimen. Less stringent goals for glycemic control are recommended for frail elderly diabetic patients with limited life expectancy, advanced diabetes complications, or extensive comorbid conditions. The aggressive management of cardiovascular risk factors, such as hypertension, dyslipidemia, obesity, inactivity or smoking, is likely to have even greater benefits.

摘要

老年2型糖尿病患者的一般治疗原则与成人护理相同。然而,低血糖和降糖治疗的其他不良反应在老年患者中更为常见。了解每类降糖药物的优缺点有助于临床医生为老年患者制定个体化治疗方案。特别是,鉴于老年人群的异质性,在使用磺脲类药物和胰岛素治疗方案之前,必须仔细考虑低血糖风险。对于预期寿命有限、患有晚期糖尿病并发症或有广泛合并症的体弱老年糖尿病患者,建议采用不太严格的血糖控制目标。积极管理心血管危险因素,如高血压、血脂异常、肥胖、缺乏运动或吸烟,可能会带来更大的益处。

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