Type 2 diabetes mellitus in elderly patients treated with endocrinologists in clinical practice

Abstract

A large-scale epidemic of type 2 diabetes mellitus (T2DM) is observed with advanced ageing worldwide. The prevalence of T2DM significantly increases with age. Therefore, this review aimed to summarise the data on T2DM in advanced and older aged patients. The primary geriatric syndromes, which should be considered for the management of older patients (cognitive impairment, sarcopenia, orthostatic hypotension, falls, urinary incontinence, senile asthenia, etc.), are presented. The causes of the high risk for hypoglycaemia in elderly patients are analysed. Improving the treatment for T2DM is a priority of modern medicine. Using antihyperglycaemic therapy is especially difficult in this population due to the high risk of hypoglycaemia and the multi-organ pathology leading to polypharmacy. Therefore, special attention is paid to treatment recommendations. Hypoglycaemic drugs used in elderly patients should be low risk of hypoglycaemia, without nephro- and hepatic toxicity, safe for cardiovascular organs, easy to administer. Furthermore, advantages and limitations of using various groups of hypoglycaemic drugs in elderly patients are discussed. DPP-4 inhibitors are also considered in detail. Modern data on mechanisms of hypoglycaemic action of DPP-4 inhibitors are presented. Possibilities of using sitagliptin in elderly patients were also considered. Finally, evidence-based studies demonstrating the obvious advantages of sitagliptin for the treatment of T2DM in the elderly and advanced aged population are discussed.

The Link Between Sleeping and Type 2 Diabetes: A Systematic Review

“…Long-term sleepers also showed an increase in insulin resistance, although the pattern was also consistently observed in the other sleep duration groups. Scholars have postulated that the deterioration of pancreatic beta cell activity resulting from severe tiredness may be the cause of the increased risk of diabetes mellitus linked to extended sleep duration [ 26 , 27 ]. The main causes of type 2 diabetes are insulin resistance and a reduction in insulin.…”

“…All illnesses, especially chronic ones like diabetes, encourage emotional responses that can negatively impact sleep [ 25 ]. Frequent breathing pauses while you are asleep are a common sleep problem called sleep apnea [ 26 ]. It has been identified as a type 2 diabetes risk factor [ 27 ].…”

“…In patients with T2DM, both excessive and insufficient sleep impairs glycemic control [ 20 ]. However, there is not enough evidence to back up a connection between T2DM and glycemic control, sleep length, or quality [ 26 ]. Thus, this study set out to perform a thorough assessment of the literature to provide more substantial evidence of the association between sleep and glycemic management in individuals with type 2 diabetes.…”