Ali A. Rizvi, MD, Professor of Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of South Carolina School of Medicine, Columbia, South Carolina, USA.

Recent therapeutic advances have seen the emergence of several oral agents for type 2 diabetes, providing an opportunity for better management of the disease. Older adults may pose a special challenge because of altered drug kinetics, the presence of other medical conditions, an increased propensity to adverse reactions, and a lack of evidence-based information for clinical decision making. Consideration should be given to treatment satisfaction, side effects, and the overall risk-benefit ratio of oral medications. It is important for providers to become familiar with the medication profiles and follow a rational initiation and titration regimen tailored to the individual patient.
Key words: diabetes, older adults, hyperglycemia, oral medications, combination therapy.