J Korean Med Assoc.  2024 Jul;67(7):449-460. 10.5124/jkma.2024.67.7.449.

Comprehensive management of polypharmacy in older patients with diabetes

• Park KS
• Yu HM

• KMID: 2558005
• DOI: http://doi.org/10.5124/jkma.2024.67.7.449

Abstract

Background
Diabetes mellitus is a complex group of chronic metabolic conditions. The incidence of frailty, sarcopenia, geriatric syndrome, and multiple chronic conditions is high in older patients with diabetes, who often require multiple medications for optimal glucose control and treatment of associated chronic complications. Unfortunately, polypharmacy is associated with a high risk of adverse outcomes, such as hypoglycemia, drug-drug interactions, and an increased socioeconomic burden in older adults with diabetes.
Current Concepts
Elderly patients with diabetes are at a high risk for polypharmacy and consequently, a high risk of adverse drug reactions. Polypharmacy is defined as the cumulative use of five or more medications. Comprehensive management and deprescribing are the most important approaches to reduce polypharmacy. Deprescription refers to reduction in or cessation of inappropriate medications.
Discussion and Conclusion
Polypharmacy continues to increase the risk of morbidity and mortality among older adults with diabetes. A comprehensive polypharmacy management and deprescription plan is warranted for significant risk reduction in elderly patients with diabetes.

Keyword

Diabetes mellitus; Aged; Polypharmacy; Comprehensive geriatric assessment; Deprescriptions; 당뇨병; 노인; 다약제; 포괄적 노인평가; 탈처방