Linagliptin use in older individuals with type 2 diabetes

Richard E Pratley1–31Florida Hospital Diabetes Institute, 2Translational Research Institute for Metabolism and Diabetes, 3Sanford-Burnham Medical Research Institute, Orlando, FL, USAAbstract: Older people have the highest prevalence of type 2 diabetes mellitus (T2DM) of a...

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Autor principal:	Pratley RE
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	DPP-4 inhibitors older individuals Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/cc2994d2d6a94bcb8b22e7117bb3ba9e
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spelling	oai:doaj.org-article:cc2994d2d6a94bcb8b22e7117bb3ba9e2021-12-02T02:45:24ZLinagliptin use in older individuals with type 2 diabetes1178-1998https://doaj.org/article/cc2994d2d6a94bcb8b22e7117bb3ba9e2014-07-01T00:00:00Zhttps://www.dovepress.com/linagliptin-use-in-older-individuals-with-type-2-diabetes-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Richard E Pratley1–31Florida Hospital Diabetes Institute, 2Translational Research Institute for Metabolism and Diabetes, 3Sanford-Burnham Medical Research Institute, Orlando, FL, USAAbstract: Older people have the highest prevalence of type 2 diabetes mellitus (T2DM) of any age group and are thus frequent users of glucose-lowering agents. Because individuals 65 years or older are underrepresented in clinical studies, there is a lack of information regarding the efficacy and safety of available treatments in this population. Additionally, a high prevalence of comorbidities, polypharmacy, and frailty can make treatment of T2DM in this population challenging. Safety is an important consideration when choosing a treatment for older individuals. Renal impairment is quite common in older patients with T2DM and can contribute to hypoglycemia. Hypoglycemia can lead to serious consequences, such as falls and fractures, and cognitive changes. As such, hemoglobin A1c treatment targets, typically <7% in the general population, are less stringent in older people, with the goal being an individualized target that balances efficacy and safety. Many glucose-lowering agents can cause adverse events detrimental to older individuals, such as hypoglycemia (insulin, sulfonylureas), weight gain (sulfonylureas, thiazolidinediones), gastrointestinal events (metformin), and fractures (thiazolidinediones), and are contraindicated or require dose adjustments in those with renal impairment (most oral/injectable agents). Orally administered dipeptidyl peptidase (DPP)-4 inhibitors have a low risk of hypoglycemia and are generally well tolerated. Linagliptin is the only DPP-4 inhibitor excreted through nonrenal pathways and therefore does not require any dose adjustment in older patients with kidney disease. This paper reviews the findings of a recent study by Barnett et al assessing the efficacy and safety of the DPP-4 inhibitor linagliptin in patients with T2DM aged 70 years or older, which concluded that linagliptin may be a useful glucose-lowering option for older patients with T2DM.Keywords: DPP-4 inhibitors, clinical trial, renal impairment, hypoglycemiaPratley REDove Medical PressarticleDPP-4 inhibitorsolder individualsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 9, Pp 1109-1114 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	DPP-4 inhibitors older individuals Geriatrics RC952-954.6
spellingShingle	DPP-4 inhibitors older individuals Geriatrics RC952-954.6 Pratley RE Linagliptin use in older individuals with type 2 diabetes
description	Richard E Pratley1–31Florida Hospital Diabetes Institute, 2Translational Research Institute for Metabolism and Diabetes, 3Sanford-Burnham Medical Research Institute, Orlando, FL, USAAbstract: Older people have the highest prevalence of type 2 diabetes mellitus (T2DM) of any age group and are thus frequent users of glucose-lowering agents. Because individuals 65 years or older are underrepresented in clinical studies, there is a lack of information regarding the efficacy and safety of available treatments in this population. Additionally, a high prevalence of comorbidities, polypharmacy, and frailty can make treatment of T2DM in this population challenging. Safety is an important consideration when choosing a treatment for older individuals. Renal impairment is quite common in older patients with T2DM and can contribute to hypoglycemia. Hypoglycemia can lead to serious consequences, such as falls and fractures, and cognitive changes. As such, hemoglobin A1c treatment targets, typically <7% in the general population, are less stringent in older people, with the goal being an individualized target that balances efficacy and safety. Many glucose-lowering agents can cause adverse events detrimental to older individuals, such as hypoglycemia (insulin, sulfonylureas), weight gain (sulfonylureas, thiazolidinediones), gastrointestinal events (metformin), and fractures (thiazolidinediones), and are contraindicated or require dose adjustments in those with renal impairment (most oral/injectable agents). Orally administered dipeptidyl peptidase (DPP)-4 inhibitors have a low risk of hypoglycemia and are generally well tolerated. Linagliptin is the only DPP-4 inhibitor excreted through nonrenal pathways and therefore does not require any dose adjustment in older patients with kidney disease. This paper reviews the findings of a recent study by Barnett et al assessing the efficacy and safety of the DPP-4 inhibitor linagliptin in patients with T2DM aged 70 years or older, which concluded that linagliptin may be a useful glucose-lowering option for older patients with T2DM.Keywords: DPP-4 inhibitors, clinical trial, renal impairment, hypoglycemia
format	article
author	Pratley RE
author_facet	Pratley RE
author_sort	Pratley RE
title	Linagliptin use in older individuals with type 2 diabetes
title_short	Linagliptin use in older individuals with type 2 diabetes
title_full	Linagliptin use in older individuals with type 2 diabetes
title_fullStr	Linagliptin use in older individuals with type 2 diabetes
title_full_unstemmed	Linagliptin use in older individuals with type 2 diabetes
title_sort	linagliptin use in older individuals with type 2 diabetes
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/cc2994d2d6a94bcb8b22e7117bb3ba9e
work_keys_str_mv	AT pratleyre linagliptinuseinolderindividualswithtype2diabetes
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Linagliptin use in older individuals with type 2 diabetes

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