Antihyperglycaemic therapy in elderly patients with type 2 diabetes: potential role of incretin mimetics and DPP-4 inhibitors


  • Disclosure
    Development of this review article was supported by an unrestricted educational grant from Novartis Pharma AG. C.M. is a consultant for Novartis Pharma AG. K.B. declares no conflicts of interests.

Chantal Mathieu,
Katholieke Universiteit Leuven,
UZ Gasthuisberg,
Herestraat 49,
3000 Leuven,
Tel.: +32 16 345970
Fax: +32 16 345934


Management of elderly patients with type II diabetes is complicated by age-related changes in physiology, comorbidities, polypharmacy and heterogeneity of functional status. A minimum goal in antidiabetic treatment in this population is to achieve a level of glycaemic control that avoids acute complications of diabetes, adverse effects and reduction in quality of life. Hypoglycaemia is a particular problem in elderly patients, and many antidiabetic agents pose increased risk for hypoglycaemia. In addition, many standard agents pose risks for older patients because of reduced renal function and common comorbidities. Newer agents based on enhancing incretin activity, including the glucagon-like peptide-1 mimetics exenatide and liraglutide and the oral dipeptidyl peptidase-4 inhibitors sitagliptin and vildagliptin, may offer particular advantages in elderly patients with diabetes.