Tags

Type your tag names separated by a space and hit enter

Cardiac risk factors and hypoglycemia in an elderly patient: how good is good enough?
Consult Pharm. 2010 Jun; 25 Suppl B:19-27.CP

Abstract

OBJECTIVES

This clinical review highlights emerging data regarding the complex relationship among glycosylated hemoglobin (A1C) goals, risk of cardiovascular disease, and hypoglycemia in elderly patients with type 2 diabetes mellitus (T2DM). According to the ADVANCE and VADT trials, lowering patients' A1C levels did not decrease the risk of cardiovascular disease, and the ACCORD trial found a slightly higher risk of cardiovascular disease with tighter glycemic control. Long-term follow-up data from the UKPDS indicated good glycemic control, when achieved early in newly diagnosed patients, lowered cardiovascular risk over the long-term (at least 15 to 20 years). Moreover, tight glycemic control, if it results in severe hypoglycemic events, may pose a serious risk among elderly patients with T2DM.

DATA SOURCES

Live symposium presentation based on clinical practice and research, medical literature, and studies published between October 2005 and January 2010 on managing diabetes in older adults, government statistics, and medical society guidelines.

CONCLUSIONS

If it can be achieved safely, early glycemic control is beneficial to elderly patients with T2DM. Treatment goals for older adults should be an individualized process and must include a number of considerations. Pharmacists need to manage the dual issues of avoiding intensive lowering of A1C levels and averting the risk of hypoglycemia.

Authors+Show Affiliations

Texas Diabetes Institute, San Antonio, Texas 78207, USA. curtis.triplitt@uhs-sa.com

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20726379

Citation

Triplitt, Curtis. "Cardiac Risk Factors and Hypoglycemia in an Elderly Patient: How Good Is Good Enough?" The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists, vol. 25 Suppl B, 2010, pp. 19-27.
Triplitt C. Cardiac risk factors and hypoglycemia in an elderly patient: how good is good enough? Consult Pharm. 2010;25 Suppl B:19-27.
Triplitt, C. (2010). Cardiac risk factors and hypoglycemia in an elderly patient: how good is good enough? The Consultant Pharmacist : the Journal of the American Society of Consultant Pharmacists, 25 Suppl B, 19-27.
Triplitt C. Cardiac Risk Factors and Hypoglycemia in an Elderly Patient: How Good Is Good Enough. Consult Pharm. 2010;25 Suppl B:19-27. PubMed PMID: 20726379.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiac risk factors and hypoglycemia in an elderly patient: how good is good enough? A1 - Triplitt,Curtis, PY - 2010/8/24/entrez PY - 2010/8/24/pubmed PY - 2010/9/3/medline SP - 19 EP - 27 JF - The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists JO - Consult Pharm VL - 25 Suppl B N2 - OBJECTIVES: This clinical review highlights emerging data regarding the complex relationship among glycosylated hemoglobin (A1C) goals, risk of cardiovascular disease, and hypoglycemia in elderly patients with type 2 diabetes mellitus (T2DM). According to the ADVANCE and VADT trials, lowering patients' A1C levels did not decrease the risk of cardiovascular disease, and the ACCORD trial found a slightly higher risk of cardiovascular disease with tighter glycemic control. Long-term follow-up data from the UKPDS indicated good glycemic control, when achieved early in newly diagnosed patients, lowered cardiovascular risk over the long-term (at least 15 to 20 years). Moreover, tight glycemic control, if it results in severe hypoglycemic events, may pose a serious risk among elderly patients with T2DM. DATA SOURCES: Live symposium presentation based on clinical practice and research, medical literature, and studies published between October 2005 and January 2010 on managing diabetes in older adults, government statistics, and medical society guidelines. CONCLUSIONS: If it can be achieved safely, early glycemic control is beneficial to elderly patients with T2DM. Treatment goals for older adults should be an individualized process and must include a number of considerations. Pharmacists need to manage the dual issues of avoiding intensive lowering of A1C levels and averting the risk of hypoglycemia. SN - 0888-5109 UR - https://www.unboundmedicine.com/medline/citation/20726379/Cardiac_risk_factors_and_hypoglycemia_in_an_elderly_patient:_how_good_is_good_enough L2 - http://www.diseaseinfosearch.org/result/9680 DB - PRIME DP - Unbound Medicine ER -