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Potential of α-Glucosidase Inhibitors in Elderly Patients with Diabetes Mellitus and Impaired Glucose Tolerance

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  • Drug Therapy
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Abstract

The prevalence of diabetes mellitus (DM) among the elderly, who constitute >20% of the population in developed countries, is high (up to 40%). Indeed, elderly people represent the bulk (≈50%) of the diabetic population. There is much evidence that better glycaemic control can reduce the morbidity associated with this disease.

α-Glucosidase inhibitors are well tolerated in the treatment of DM in this population. They reduce postprandial hyperglycaemia and have a moderate effect on fasting plasma glucose levels, resulting in a significant reduction in glycated haemoglobin (HbA1C) levels. α-Glucosidase inhibitors can be used either as monotherapy or in combination with other oral hypoglycaemic agents or insulin. The good safety profile of these drugs makes them suitable for use in elderly patients with type 2 (non-insulin-dependent) DM, because they can achieve substantial metabolic improvements without any additional risks. Thus, the use of α-glucosidase inhibitors should be considered: (i) as a first-choice treatment in newly diagnosed patients; (ii) in individuals whose DM is not well controlled with any other type of treatment; or (iii) as an alternative to sulphonylureas or biguanides in patients at risk from hypoglycaemia or lactic acidosis, respectively.

Despite the numerous potential advantages of α-glucosidase inhibitors in elderly patients with type 2 DM, there is a lack of studies focusing specifically on that population. However, such studies are under way. In addition, the potential of α-glucosidase inhibitors in the prevention of type 2 DM and/or on macrovascular disease is currently under study.

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  1. Research Group on Diabetes and Metabolic Regulation Research Center, Centre Hospitalier de l’Université de Montréal, Campus Hôtel-Dieu, and Department of Medicine, University of Montreal, Montréal, Québec, Canada

    Rémi Rabasa-Lhoret &  Jean-Louis Chiasson

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  1. Rémi Rabasa-Lhoret
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Correspondence to Jean-Louis Chiasson.

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Rabasa-Lhoret, R., Chiasson, JL. Potential of α-Glucosidase Inhibitors in Elderly Patients with Diabetes Mellitus and Impaired Glucose Tolerance. Drugs & Aging 13, 131–143 (1998). https://doi.org/10.2165/00002512-199813020-00005

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