Type 2 diabetes mellitus in old age
Authors:
MUDr. Martina Lášticová
Authors‘ workplace:
III. interní gerontologická a metabolická klinika LF UK a FN Hradec Králové
Published in:
Geriatrie a Gerontologie 2014, 3, č. 2: 88-91
Category:
Review Article
Overview
Older patients with diabetes suffer increased morbidity and mortality in comparison to elderly patients without diabetes. Other frequent problems in these patients are polypharmacy, functional disability and geriatric syndromes – cognitive impairment, depression, urinary incontinence and falls. When deciding about the treatment and glycaemic targets it is necessary to take into account the pa-tient‘s level of independence and his or her physical and mental abilities. Risk of hypoglycaemia, which is increased in this group of patients and which might lead to impaired cognitive function and functional disability, is an important factor in choosing antidiabetic medication.
Key words:
older patients – diabetes – hypoglycaemia – geriatric syndromes
Sources
1. Adler GK, Bonyhay I, Failing H, et al. Antecendent hypoglycemia impairs autonomic cardiovascular function: implications for rigorous glycemic control. Diabetes 2009; 58: 360.
2. Amati F, Dubé JJ, Coen PM, et al. Physical inactivity and obesity underlie the insulin resistance of aging. Diabetes Care 2009; 29: e176–e179.
3. American Diabetes Association. Standards of medical care in diabetes, 2012; 35 (Suppl. 1): S11–S63.
4. Anderson RJ, Freedland KE, Dlouze RE, et al. The prevalence of comorbid depression in adults with diabetes: a meta-analysis. Diabetes Care 2001; 24: 1069.
5. Barnett AH, Husman H, Jones R et al. Linagliptin for patiens aged 70 years or older with type 2 diabetes inadequately controlled with common antidiabetes treatments: a randomised, double-blind, placebo-controlled trial. Lancet 2013; 382 (9902):1413–1423.
6 . Betel MA, Sloan FA, Belsky D, Feinglos MN. Longitudinal incidence and prevalence of adverse outcomes of diabetes mellitus in elderly patients. Arch Intern Med 2007; 167: 921.
7. Biessels GJ, Staekenborg S, Brunner E, et al. Risk of dementia in diabetes mellitus: a systematic review. Lancet Neurol 2006; 5(1): 64–74.
8. Chang AM, Halter JB. Aging and insulin secretion. Am J Physiol Endocrinol Metab 2003; 284: E7–E12.
9. Cowie CC, Rust KF, Ford ES, et al. Full accounting of diabetes and prediabetes in the U.S. population in 1988–1994 and 2005–2006. Diabetes Care 2009; 32: 287.
10. Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach. Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care, Diabetologia. 19 April 2012
11. Ligthelm RJ, Kaiser M, Vora J, Yale JF. Insulin use in elderly adults: risk of hypoglycemia and strategy for care. J Am Geriatr Soc 2012; 60: 1564.
12. Lipska KJ, Bailey CJ, Inzucchi SE. Use of metformin in the setting of mild-to-moderate renal insufficiency. Diabetes Care 2011; 34: 1431–1437.
13. Maedler K, Schumann DM, Schulthess F, et al. Aging correlates with decreased beta-cell proliferative capacity and enhanced sensitivity to apoptosis: a potential role for Fas and pancreatic duodenal homeobox-1. Diabetes 2006; 55: 2455–2462.
14. Miller SL, Wolfe RR. The Danger of weight loss in the elderly. J Nutr Health Aging 2008; 12: 487–491.
15. Mooradian AD, Perryman K, Forten, et al. Cortical function in elderly non-insulin dependent diabetic patients. Behavioral and electrophysiologic studies. Arch Intern Med 1988; 148: 2369.
16. Nauck M, Stöckmann F, Bert R, Creutzfeldt W. Reduced incretin effect in Type 2 (non-insulin-dependent) diabetes. Diabetologia 1986; 29(1): 46–52.
17. Schwarz AV, Vittinghof E, Sellmeyer DE, et al. Diabetes-related complications, glycemic control, and falls in older adults. Diabetes Care 2008; 31(3): 391–396.
18. Shorr RI, Ray WA, Daugherty JR, Griffin MR. Incidence and risk factors for serious hypoglycemia in older persons using insulin or sulfonylureas. Arch Intern Med 1997; 157: 1681.
19. Short RI, Ray WA, Daugherty JR, Griffin MR. Individual sulfonylureas and serious hypoglycemia in older people. J Am Geriatr Soc 1996; 44: 751–755.
20. Sue Kirkman M, Briscoe VJ, Clark N, et al. Diabetes in older adults: a consensus report. J Am Geriatr Soc 2012; 60: 2342.
21. Svačina Š. Obezitologie a teorie metabolického syndromu. Praha, Triton 2013.
22. Svačina S, Karen I, Juračková B. Diabetes mellitus – léčba u starších pacientů v ČR. Doporučené diagnostické a terapeutické postupy pro všeobecné praktické lékaře. www.svl.cz
23. Villareal DT, Banks M, Skener C, et al. Physical frailty and body composition in obese elderly men and women. Obes Res 2004; 12: 913–920.
24. Whitmer RA, Karter AJ, Arge K, et al. Hypoglycemic episodes and the risk of dementia in older patiens with type 2 diabetes mellitus. JAMA 2009; 301: 1565.
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Geriatrics General practitioner for adults Orthopaedic prostheticsArticle was published in
Geriatrics and Gerontology
2014 Issue 2
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