Type 2 diabetes: aspects of antihyperglycemic therapy in elderly patients

Increase in number of patients with type 2 diabetes mellitus (T2D) in old age is due to the improvement of approaches to early diagnosis of complications and, consequently, the reduction of mortality at an earlier age, and the continuous development of new drugs with a high profile of safety makes it an important task for the doctor to determine an effective and safe treatment regimen for diabetes in the older age group. The article is devoted to the peculiarities of diabetes in elderly patients. Difficulties in management of such patients are due to the small number of studies conducted, which allow us to draw unequivocal conclusions about the most appropriate treatment regimens. Physiological changes in aging, pathological processes in comorbidities do not allow to establish strict glucose control in elderly and senile patients. Authors present the factors determining the peculiarities of the choice of antihypoerglycemic therapy in the elderly. Different variants of treatment depending on comorbid pathology, degree of severity of senile asthenia syndrome are described. Tableted sugar-reducing drugs for the treatment in the elderly are considered, as well as a step-by-step approach to the correction of hyperglycemia in insulin therapy, and target levels of glycated hemoglobin depending on the severity of concomitant diseases are individualized.