Transforming Diabetes Care:
The Role of DPP4i for Patients with Special Needs
2 September 2026
Dr Ip Tai Pang
MBBS (HK), MRCP (UK), FHKCP, FHKAM (Medicine), FRCP (Edin)
Abstract
Managing Type 2 diabetes mellitus (T2DM) in elderly populations requires an individualized, holistic approach that factors in frailty, cognitive status, and comorbidities. The primary clinical objective is maintaining stable glycemic control while strictly avoiding hypoglycemia, reducing polypharmacy burdens, and improving overall quality of life. While recent pharmacological milestones have introduced newer classes of anti-diabetic drugs with established cardiorenal benefits, their specific impact on the very elderly remains understudied and requires cautious initiation. Metformin remains a key first-line treatment when renal function allows, while DPP-4 inhibitors offer a safe, well-tolerated second-line option, particularly for frail individuals.

Dr Ip Tai Pang
MBBS (HK), MRCP (UK), FHKCP, FHKAM (Medicine), FRCP (Edin)
Specialist in Endocrinology, Diabetes & Metabolism, Honorary Clinical Associate Professor, School of Clinical Medicine, the University of Hong Kong






































