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Management of diabetes in the elderly with canagliflozin: A newer hypoglycemic drug on the horizon.

Sehgal V, Bajwa SJ, Sehgal R, Consalvo JA - J Pharmacol Pharmacother (2014)

Bottom Line: Canagliflozin is the first available oral inhibitor of sodium/glucose cotransporter 2 (SGLT2) in the market.The clinician needs to be circumspect about potential drug interactions, especially when there is an underlying chronic kidney disease (CKD) and congestive heart failure (CHF).Also its use is best avoided in people who are predisposed to genital mycotic and urinary tract infections (UTI).

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, The Commonwealth Medical College, Scranton, Pennsylvania, USA.

ABSTRACT
Canagliflozin is the first available oral inhibitor of sodium/glucose cotransporter 2 (SGLT2) in the market. At the outset it sounds excellent for the use in the elderly diabetic population, because of its minimal tendency to cause hypoglycemia. However, the clinician needs to exercise caution as it needs to be dosed renally. The clinician needs to be circumspect about potential drug interactions, especially when there is an underlying chronic kidney disease (CKD) and congestive heart failure (CHF). Also its use is best avoided in people who are predisposed to genital mycotic and urinary tract infections (UTI).

No MeSH data available.


Related in: MedlinePlus

Pitfalls of HBA1C monitoring in the elderly
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Figure 1: Pitfalls of HBA1C monitoring in the elderly

Mentions: This also complicates the diagnosis and monitoring of diabetes in the elderly. In the elderly, HbA1c[8] should be interpreted with cynicism, keeping in view the comorbidities of the changing body physiology. In the elderly, it could be a misleading diagnostic tool. In rapid cell turnover states like hemolytic anemia, HbA1c could be falsely low. During treatment with iron, B12 or erythropoietin, as in chronic kidney disease (CKD), there may be rapid red blood cell turnover and falsely low HbA1c.[9] On the other hand, in low cell turnover states, especially iron, B12 or folate deficiency or in the very elderly, when the marrow turnover is low, HbA1c may be falsely high. In CKD, HbA1c may be falsely high or low. When there is high carbamylated hemoglobin it may be falsely high and if erythropoietin is being used it may be falsely low [Figure 1].


Management of diabetes in the elderly with canagliflozin: A newer hypoglycemic drug on the horizon.

Sehgal V, Bajwa SJ, Sehgal R, Consalvo JA - J Pharmacol Pharmacother (2014)

Pitfalls of HBA1C monitoring in the elderly
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231550&req=5

Figure 1: Pitfalls of HBA1C monitoring in the elderly
Mentions: This also complicates the diagnosis and monitoring of diabetes in the elderly. In the elderly, HbA1c[8] should be interpreted with cynicism, keeping in view the comorbidities of the changing body physiology. In the elderly, it could be a misleading diagnostic tool. In rapid cell turnover states like hemolytic anemia, HbA1c could be falsely low. During treatment with iron, B12 or erythropoietin, as in chronic kidney disease (CKD), there may be rapid red blood cell turnover and falsely low HbA1c.[9] On the other hand, in low cell turnover states, especially iron, B12 or folate deficiency or in the very elderly, when the marrow turnover is low, HbA1c may be falsely high. In CKD, HbA1c may be falsely high or low. When there is high carbamylated hemoglobin it may be falsely high and if erythropoietin is being used it may be falsely low [Figure 1].

Bottom Line: Canagliflozin is the first available oral inhibitor of sodium/glucose cotransporter 2 (SGLT2) in the market.The clinician needs to be circumspect about potential drug interactions, especially when there is an underlying chronic kidney disease (CKD) and congestive heart failure (CHF).Also its use is best avoided in people who are predisposed to genital mycotic and urinary tract infections (UTI).

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, The Commonwealth Medical College, Scranton, Pennsylvania, USA.

ABSTRACT
Canagliflozin is the first available oral inhibitor of sodium/glucose cotransporter 2 (SGLT2) in the market. At the outset it sounds excellent for the use in the elderly diabetic population, because of its minimal tendency to cause hypoglycemia. However, the clinician needs to exercise caution as it needs to be dosed renally. The clinician needs to be circumspect about potential drug interactions, especially when there is an underlying chronic kidney disease (CKD) and congestive heart failure (CHF). Also its use is best avoided in people who are predisposed to genital mycotic and urinary tract infections (UTI).

No MeSH data available.


Related in: MedlinePlus