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Considerations in the Management of
Older Adults with Diabetes

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Overview

Currently, 20% of individuals 65 years or older, are diagnosed with diabetes mellitus (DM) and the risk increases with advancing age. The treatment of older adults with DM must take into consideration a number of non-drug and drug-specific factors. For example, besides advanced age, long-standing diabetes, coexisting health conditions, and hypoglycemia unawareness (a decreased ability to recognize the symptoms of hypoglycemia) predispose elders to hypoglycemia. Hypoglycemia has been linked with an increased risk of both adverse cardiovascular events and dementia. Because of these concerns, current national guidelines for diabetes goals and management may not be appropriate for all older adults.

This issue discusses major geriatric considerations in the treatment of DM. It summarizes the benefits and risks of oral and injectable medications based on glucose control, tolerability, coexisting conditions, and ease of use in older adults.

Details

Publication Date: 02/01/2011
Expiration Date: 02/01/2014
CE Credit: 1.5 (0.15 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Joshua J. Neumiller, PharmD, CDE, CGP, FASCP, Assistant Professor of Pharmacotherapy, College of Pharmacy, Washington State University & Elder Services of Spokane, and Patrick K. Tabon, PharmD Candidate 2012, Washington State University.

Disclosure Statement

Dr. Neumiller receives research grant support from Merck, Novo Nordisk, Amylin, and Johnson & Johnson. Mr. Tabon reports no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Guest Editorial Advisor

Lisa Kroon, Pharm.D., CDE, Professor & Executive Vice Chair, Department of Clinical Pharmacy, School of Pharmacy, University of California at San Francisco.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Discuss patient specific considerations when treating older persons with diabetes.
    2. Discuss recent data, guidelines, and counseling points pertaining to the treatment of older adults with diabetes.
    3. Outline safety and efficacy considerations for each class of medications currently available and discuss these considerations in the context of treating older adults with diabetes.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc. Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.5 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Editor and CE Administrator

Terry M. Baker, PharmD

Associate Editor and CE Coordinator

Tracy Farnen, PharmD

Associate Editors

James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Ron Finley, RPh
Lecturer
Department of Clinical Pharmacy
University of California San Francisco
San Francisco, CA

Associate Member of the UCSF Memory and Aging Center
Alzheimer's Research Center

Consultant Pharmacist to the Institute on Aging-On Lok Senior Health
Institute on Aging Alzheimer's Day Care Center

Angie S. Graham, PharmD
Drug Information Coordinator
Stanford Hospital and Clinics
Stanford University Medical Center
Stanford, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Joshua J. Neumiller, PharmD, CDE, CGP, FASCP
Assistant Professor
Department of Pharmacotherapy
College of Pharmacy
Washington State University
And
Elder Services of Spokane
Spokane, WA

Candy Tsourounis, PharmD
Professor of Clinical Pharmacy
Medication Outcomes Center
Department of Clinical Pharmacy
School of Pharmacy
University of California, San Francisco
San Francisco, CA

Senior Editorial Advisor

Gerard Hatheway, PharmD, PhD

Editorial Advisors

Jocelyn Chan, PharmD
Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD


Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners

Emily K. Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

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