The application of the STOPP/START criteria in the elderly patients with type 2 diabetes mellitus and essential hypertension at the endocrinology department of a multidisciplinary hospital

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.

Download Full-text

Analysis of drug prescription appropriateness according to the STOPP/START criteria of the elderly patients with type 2 diabetes mellitus in the endocrinology department of a multi-speciality hospital

Russian Journal of Geriatric Medicine ◽

10.37586/2686-8636-1-2020-47-56 ◽

2020 ◽

pp. 47-56

Author(s):

A. I. Kochetkov ◽

V. A. De ◽

N. Yu. Voevodina ◽

M. V. Chachiashvili ◽

A. V. Grishina ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Elderly Patients ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Peripheral Vascular ◽

Start Criteria ◽

History Of

To assess the appropriateness of prescribed drugs according to the STOPP/START criteria of elderly patients with type 2 diabetes mellitus (T2DM) in the endocrinology department of a multi-speciality hospital.Medical records of 136 patients ≥65 years old with T2DM hospitalized in the endocrinology department of the multi-speciality hospital (Moscow, Russia) were analyzed according to the «STOPP/START» criteria.The analysis of prescription leaflets has identified 30 potentially not recommended drugs (46 patients [33,8%]), the use of which should be avoided in certain clinical situations. Also the analysis has identified 175 medications that should be considered for elderly patients with certain conditions (89 patients [65,4%]). The most frequent identified STOPP criteria were: «Glibenclamide or chlorpropamide or glimepiride with T2DM» (23,3%); «Non-steroidal anti-inflammatory drug (NSAID) with history of peptic ulcer disease or gastro-intestinal bleeding, unless with concurrent histamine H2 receptor antagonist, proton pump inhibitors or misoprostol» (13,3%) and «NSAID with estimated glomerular filtration rate 20–50 ml/min/1.73m2» (3%). The most frequent START criteria were: «Statin therapy with a documented history of coronary, cerebral or peripheral vascular disease, where the patient’s functional status remains independent for activities of daily living and life expectancy is >5 years» (25,1%); «Сlopidogrel with a documented history of cerebral or peripheral vascular disease» (18,9%); «Aspirin with a documented history of atherosclerotic coronary disease in patients with sinus rhythm» (18,3%).In patients ≥ 65 years old with T2DM potentially not recommended drugs are often administrated and there are no prescriptions for some appropriate drugs required in certain clinical settings. The findings give evidence of the need to optimization of pharmacotherapy in elderly and senile patients with T2DM. This adaptation will improve the patients’ quality of life and avoid wasteful spending.

Download Full-text

Cognitive impairment and MRI correlates in the elderly patients with type 2 diabetes mellitus

Age and Ageing ◽

10.1093/ageing/afl180 ◽

2007 ◽

Vol 36 (2) ◽

pp. 164-170 ◽

Cited By ~ 101

Author(s):

B. van Harten ◽

J. Oosterman ◽

D. Muslimovic ◽

B.-J. P. van Loon ◽

P. Scheltens ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cognitive Impairment ◽

Elderly Patients ◽

The Elderly

Download Full-text

Abstract #295 GLP-1 Receptor Agonists and Death From Any Cause in Elderly Patients with Type 2 Diabetes Mellitus: A Post-Hoc Analysis

Endocrine Practice ◽

10.1016/s1530-891x(20)47140-x ◽

2018 ◽

Vol 24 ◽

pp. 80-81

Author(s):

Konstantinos Toulis ◽

Krishna Gokhale ◽

G. Neil Thomas ◽

Wasim Hanif ◽

Krishnarajah Nirantharakumar ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Elderly Patients ◽

Post Hoc Analysis ◽

Receptor Agonists ◽

Post Hoc

Download Full-text

399-P: Deintensification of Diabetes Treatment in Elderly Patients with Type 2 Diabetes Mellitus

Diabetes ◽

10.2337/db19-399-p ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 399-P

Author(s):

DANIELA V. PIRELA ◽

RAJESH GARG

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Elderly Patients ◽

Diabetes Treatment

Download Full-text

Association of serum cystatin C and risk of mild cognitive impairment in elderly patients with type 2 diabetes mellitus

Academic Journal of Second Military Medical University ◽

10.3724/sp.j.1008.2011.01122 ◽

2011 ◽

Vol 31 (10) ◽

pp. 1122-1125

Author(s):

Lan LUO ◽

Yu-hong HU ◽

Xi-ping TUO

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Elderly Patients ◽

Cystatin C ◽

Serum Cystatin C ◽

Serum Cystatin

Download Full-text

A Narrative Review on Sarcopenia in Type 2 Diabetes Mellitus: Prevalence and Associated Factors

Nutrients ◽

10.3390/nu13010183 ◽

2021 ◽

Vol 13 (1) ◽

pp. 183

Author(s):

Anna Izzo ◽

Elena Massimino ◽

Gabriele Riccardi ◽

Giuseppe Della Pepa

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Elderly Population ◽

The Elderly ◽

Narrative Review ◽

Macrovascular Complications ◽

Diabetic Patients ◽

Age Related

Type 2 diabetes mellitus (T2DM) represents a major health burden for the elderly population, affecting approximately 25% of people over the age of 65 years. This percentage is expected to increase dramatically in the next decades in relation to the increased longevity of the population observed in recent years. Beyond microvascular and macrovascular complications, sarcopenia has been described as a new diabetes complication in the elderly population. Increasing attention has been paid by researchers and clinicians to this age-related condition—characterized by loss of skeletal muscle mass together with the loss of muscle power and function—in individuals with T2DM; this is due to the heavy impact that sarcopenia may have on physical and psychosocial health of diabetic patients, thus affecting their quality of life. The aim of this narrative review is to provide an update on: (1) the risk of sarcopenia in individuals with T2DM, and (2) its association with relevant features of patients with T2DM such as age, gender, body mass index, disease duration, glycemic control, presence of microvascular or macrovascular complications, nutritional status, and glucose-lowering drugs. From a clinical point of view, it is necessary to improve the ability of physicians and dietitians to recognize early sarcopenia and its risk factors in patients with T2DM in order to make appropriate therapeutic approaches able to prevent and treat this condition.

Download Full-text