title: Treatment of type 2 diabetes mellitus in the older adult: a review.
abstract: OBJECTIVE
  This review summarizes the particular challenges of diabetes in older individuals and the evidence base guiding the selection of treatment targets and strategies in this population.
  
  
  METHODS
  An in-depth literature search was conducted to identify the evidence base from randomized, controlled, and population-based epidemiological studies, as well as guidelines derived from expert opinion.
  
  
  RESULTS
  Older patients are a highly heterogeneous population with respect to the pathogenesis and course of diabetes and, as a group, manifest significant comorbidities that impact treatment goals and strategies. There is a lack of consensus regarding "optimal" glucose targets in older patients with diabetes. Hypoglycemia is more common in the older patient, contributes to increased morbidity and reduced quality of life, and limits treatment in many cases. Duration of diabetes, comorbidities, life expectancy, and functional status are other important factors to consider when identifying appropriate glycemic goals and choosing an antihyperglycemic agent for older patients with type 2 diabetes mellitus (T2DM).
  
  
  CONCLUSIONS
  Current, limited treatment recommendations in older patients with T2DM are based on expert opinion due to the general lack of evidence from randomized controlled trials. This underscores the importance of individualizing pharmacologic therapy in these patients with a focus on the risk-to-benefit ratio. Additional trials in older patients are needed to assess drug safety, efficacy, and dosing.
authors: Florida Hospital Diabetes and Translational Research Institutes, Sanford Burnham Medical Research Institute, Orlando, Florida.
authors: Richard E
authors: RE
authors: Pratley
authors: Sheffield Teaching Hospitals Foundation Trust, University of Sheffield, Sheffield, United Kingdom.
authors: Simon R
authors: SR
authors: Heller
authors: Eli Lilly and Company, Indianapolis, Indiana.
authors: Mary Alice
authors: MA
authors: Miller
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008019:Life Style
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents