Greater understanding of the complex pathogenesis of type 2 diabetes (T2D), which comprises eight core defects (the ominous octet), has resulted in the development and introduction of new classes of glucose-lowering therapies, the use of which should be tailored according to individual glycemic defects. |
Timely escalation of therapy is required for optimal glycemic control, but is often hampered by the traditional ‘sequential’ approach to treatment that does not address the multiple pathophysiologic defects of T2D. |
The therapeutic approach in older (≥ 65 years of age) patients with T2D is complicated by their clinical, cognitive, and functional heterogeneity, polypharmacy and risk of hypoglycemia, with guidelines recommending individualized, less stringent glycemic targets balanced against the risk of hypoglycemia. |
Here, we review different treatment options for older patients with T2D, with a focus on the pros and cons associated with the use of glucose-lowering therapies in older patients, with emphasis on insulin therapy and glucagon-like peptide-1 receptor agonists. |
In particular, this manuscript reviews data supporting the rationale for the safe and effective use of a fixed-ratio combination comprising insulin glargine 100 units/mL and the glucagon-like peptide-1 receptor agonist, lixisenatide, in older patients with T2D. |
Open Access 23.10.2019 | Review
Combining GLP-1 Receptor Agonists and Basal Insulin in Older Adults with Type 2 Diabetes: Focus on Lixisenatide and Insulin Glargine
Erschienen in: Advances in Therapy | Ausgabe 12/2019