title: Special considerations for the use of insulin in older adults.
abstract: OBJECTIVE
  The goal of this article is to provide guidance in prescribing insulin for older adults.
  
  
  BACKGROUND
  The prevalence of diabetes increases with age, with almost 30% of the elderly population diagnosed with this metabolic disorder. Along with the well-documented microvascular and microvascular complications of diabetes, older adults are at increased risk of numerous other complications, such as dementia, risk of falling, frailty, and incontinence.
  
  
  RESULTS
  Whether designing a new insulin regimen or adjusting an existing regimen, many factors must be considered; these include advantages and disadvantages of each insulin option; adverse events, particularly hypoglycemia and increased risk of falls; and comorbid conditions. When assessing insulin options for older adults, a thorough evaluation of key features, such as the pharmacokinetics and timing of administration in relation to meals, along with cost, will assist clinicians in selecting an appropriate regimen. Hypoglycemia and risk of falls are increased in older adults; tight glycemic goals must be weighed against the risk of these adverse events. The presence of comorbid conditions may interfere with older adults' ability to inject insulin and monitor their blood sugar appropriately. Specialized devices, such as insulin pens, may offer a means to assist older adults with their insulin therapy.
  
  
  CONCLUSIONS
  Prescribing insulin to older patients must be individualized and tailored to meet the needs of each individual.
authors: Massachusetts College of Pharmacy and Health Sciences, Worcester, MA 01608, USA. kaelen.dunican@mcphs.edu
authors: Kaelen C
authors: KC
authors: Dunican
authors: Alicia R
authors: AR
authors: Desilets
mesh_terms: D000058:Accidental Falls; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007332:Insulin Infusion Systems
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin