Quelle place pour les nouveaux antidiabétiques dans la prise en charge du diabète du sujet âgé ?

New pharmacologic agents, such as 'incretins' (dipeptidyl peptidase [DPP]-4 inhibitors; glucagon-like peptide-1 receptor agonists) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors, which act on different pharmacologic targets than insulin sensitizers and sulfonylureas have recently been introduced for the treatment of type 2 diabetes, offering useful alternatives in the case of intolerance, contraindications, or therapeutic failure of the classical therapeutic combinations. However, except for DPP-4 inhibitors (gliptins), these drugs have not been extensively studied in elderly patients, particularly in frail ones. Despite of some uncertainties due to the lack of long term experience in this population, and provided that the possible adverse effects are carefully looked after and the contraindications respected, available pharmacodynamics and clinical data suggest that some of these drugs could reduce the important iatrogenesis of the antidiabetic medications, and may have a place of choice in frail diabetic patients.