How to approach to the therapy of diabetes in the elderly

WEBER, Pavel, Dana WEBEROVÁ and Hana MELUZÍNOVÁ. How to approach to the therapy of diabetes in the elderly. Advances in Gerontology. St. Petersburg: Springer Science + Business Media, 2014, vol. 27, No 3, p. 519-530. ISSN 2079-0570.

Basic information

• Original name: How to approach to the therapy of diabetes in the elderly
• Authors: WEBER, Pavel (203 Czech Republic, guarantor, belonging to the institution), Dana WEBEROVÁ (203 Czech Republic, belonging to the institution) and Hana MELUZÍNOVÁ (203 Czech Republic, belonging to the institution).
• Edition: Advances in Gerontology, St. Petersburg, Springer Science + Business Media, 2014, 2079-0570.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30200 3.2 Clinical medicine
• Country of publisher: Russian Federation
• Confidentiality degree: is not subject to a state or trade secret
• RIV identification code: RIV/00216224:14110/14:00078259
• Organization unit: Faculty of Medicine
• Keywords in English: advanced age; multi-morbidity; geriatric syndromes; poly-pharmacy; diabetes mellitus; specifics; hypoglycemia; T2DM; treatment; oral anti-diabetic drugs; insulin
• Tags: EL OK
• Tags: Reviewed

Abstract

In gerontology diabetes mellitus (DM) is clinically the most frequent and extremely serious metabolic disorder. DM is an important health issue across the globe. With increasing life expectancy physicians are called upon to manage diabetes in the elderly more often. Senior patients suffer predominantly from the type 2 DM — T2DM (70+ up to 90–95 %). Apart from genetic predisposition and an environmental infl uence, nutritional habits, modern lifestyle, stress and minor physical activity are of particular importance. Treatment options for T2DM in the elderly are diet, physical activity, various oral anti-diabetic drugs and insulin. At the start of treatment should primarily take into account: patient’s age; self-suffi ciency; late micro- and macro-vascular complications; social status; nutritional assessment (incl. dental status); other handicaps — psychic, motoric, visual and aural. Especially in frail, elderly patients, there should be less emphasis on strict glycaemic control than on avoiding malnutrition and hypoglycemia and achieving the best possible quality of life. Therapy of DM in this population is tightly connected with signifi cant risks of microand macrovascular complications on one hand, and possible problems of the treatment (e.g. hypoglycemia) with intensive control on the other hand. To realize a comprehensive approach to therapy of diabetes in the old age a holistic approach with main aim improving quality of life is necessary.