Noninsulin treatment of type 2 diabetes mellitus in geriatric patients: a review.

Abstract Background Currently, 42% of the US population with diabetes is aged ≥65 years. Objective The aim of this review was to discuss the efficacy and tolerability of noninsulin therapies for type 2 diabetes mellitus (T2DM), with an emphasis on patients aged ≥65 years. Methods PubMed and EMBASE (1977−2010) were searched using the terms geriatric, elderly patients, type 2 diabetes mellitus, metformin, secretagogues, thiazolidinediones (TZDs), alpha-glucosidase inhibitors, dipeptidyl peptidase-4 (DPP-4) inhibitors, and glucagon-like peptide-1 (GLP-1) receptor agonists . Articles were included if they were clinical trials, reviews, or meta-analyses. Results More than 10 classes of noninsulin treatments are available for T2DM. However, most treatments have been evaluated only in trials in patients aged P Conclusions The selection of noninsulin treatments in older patients with T2DM should be individualized based on patient assessment and on careful evaluation of the potential benefits (glycemic and extraglycemic) and risks (ie, hypoglycemia, weight gain, cardiovascular risks). More clinical trials in older patients, especially those aged ≥65 years, with T2DM are needed.