Zeyfang A
AGAPLESION Bethesda Krankenhaus Stuttgart, Hohenheimerstr. 21, 70184, Stuttgart, Deutschland.
Institut für Epidemiologie, Universität Ulm, Albert-Einstein-Allee 41, 89081, Ulm, Deutschland.
Internist (Berl). 2016 May;57(5):502-7. doi: 10.1007/s00108-016-0039-5.
A majority of older people with type 2 diabetes are multimorbid, frail or have limitations in functions. Polypharmacotherapy is unfortunately a frequent occurrence and dangerous. In particular the administration of antihyperglycemic therapy must be carefully weighed up against the risks associated with hypoglycemia.
The conditions and characteristics of older persons with diabetes are highlighted with respect to the use of individualized therapy of diabetes.
The advantages and disadvantages of oral antidiabetic agents, insulins and substances with novel active principles, such as gliflozin drugs are discussed. Established oral therapeutic drugs, such as metformin as well as the new substance groups, such as gliptins are advantageous in this patient group. Injection-based therapies with glucagon-like peptide 1 (GLP-1) mimetics and the new insulins can also expand the spectrum of therapy if they are prudently used.
大多数老年2型糖尿病患者患有多种疾病、身体虚弱或存在功能受限问题。不幸的是,多重用药很常见且具有危险性。特别是降糖治疗的用药必须仔细权衡低血糖相关风险。
强调老年糖尿病患者在使用个体化糖尿病治疗方面的情况和特征。
讨论了口服降糖药、胰岛素以及具有新活性成分的物质(如钠-葡萄糖协同转运蛋白2抑制剂)的优缺点。已确立的口服治疗药物(如二甲双胍)以及新的药物类别(如二肽基肽酶-4抑制剂)在该患者群体中具有优势。如果谨慎使用,基于注射的胰高血糖素样肽-1(GLP-1)类似物疗法和新型胰岛素也可扩大治疗范围。