Diabetes mellitus in older adults from the point of view of the clinical diabetologist
Authors:
Alena Šmahelová
Authors‘ workplace:
Diabetologické centrum a subkatedra LF UK a FN Hradec Králové
Published in:
Vnitř Lék 2016; 62(Suppl 4): 119-122
Category:
Reviews
Overview
Disorders of glucose homeostasis affect quite a large part of the older population and their incidence including manifest diabetes is growing. Diabetes in older adults is associated with an increased risk of geriatric syndrome expressed in various ways (decrease in muscle size, functional disability, frailty) and early mortality. Diabetes care for the elderly requires, also in view of heterogeneity of diabetes itself, an individual specific approach. This involves not only diagnostics and a clinical picture, but also the treatment goals and the therapy of diabetes and complications in itself. Diabetes treatment includes both regimen adjustments and use of antidiabetic drugs in different combinations and regimens in accordance with up-to-date specialist recommendations.
Key words:
treatment goals – diabetes mellitus – pharmacological therapy – age
Sources
1. Cowie CC, Rust KF, Ford ES et al. Full accounting of diabetes and pre-diabetes in the U.S. population in 1988–1994 and 2005–2006. Diabetes Care 2009; 32(2): 287–294. Dostupné z DOI: <http://dx.doi.org/10.2337/dc08–1296>. Erratum in Diabetes Care. 2011; 34(10): 2338.
2. Šmahelová A. Diabetes a stáří. In Karen I, Svačina Š. Diabetes mellitus v primární péči. 2.vyd. Axonite CZ: Praha 2014: 226–232. ISBN 978–80–904899–8-1.
3. Goulet ED, Hassaine A, Dionne IJ et al. Frailty in the elderly is associated with insulin resistance of glucose metabolism in the postabsorptive state only in the presence of increased abdominal fat. Exp Gerontol 2009; 44(11): 740–744. Dostupné z DOI: <http://dx.doi.org/10.1016/j.exger.2009.08.008>.
4. Pani LN, Korenda L, Meigs JB et al. Effect of aging on A1C levels in individuals without diabetes: evidence from the Framingham Offspring Study and the National Health and Nutrition Examination Survey 2001–2004. Diabetes Care 2008; 31(10): 1991–1996. Dostupné z DOI: <http://dx.doi.org/10.2337/dc08–0577>.
5. [American Diabetes Association]. Standards of medical care in diabetes – 2012. Diabetes Care 2012; 35(Suppl 1): S11-S63. Dostupné z DOI: <http://dx.doi.org/10.2337/dc12-s011>.
6. Sinclair AJ (ed). Diabetes in Old Age. Wiley Diabetes in Practice Series. 3rd ed. John Wiley & Sons 2009. ISBN 978–0-470–06562–4.
7. Doporučené diagnostické a terapeutické postupy pro všeobecné praktické lékaře. Diabetes mellitus. Léčba u starších pacientů v ČR. Centrum doporučených postupů pro praktické lékaře. 1. ed. 2014.
8. Whitmer RA, Karter AJ, Yaffe K et al. Hypoglycemic Episodes and Risk of Dementia in Older Patients with Type 2 Diabetes Mellitus.JAMA 2009; 301(15): 1565–1572. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2009.460>.
9. Shin YK, Cong WN, Cai H et al. Age-related changes in mouse taste bud morphology, hormone expression, and taste responsivity. J Gerontol A Biol Sci Med Sci 2012; 67(4): 336–344. Dostupné z DOI: <http://dx.doi.org/10.1093/gerona/glr192>.
10. Colberg SR, Sigal RJ, Fernhall B et al. [American College of Sports Medicine; American Diabetes Association]. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement executive summary. Diabetes Care 2010; 33(12): 2692–2696. Dostupné z DOI: <http://dx.doi.org/10.2337/dc10–1548>.
11. Chiniwala N, Jabbour S. Management of diabetes mellitus in the elderly. Curr Opin Endocrinol Diabetes Obes 2011; 18(2): 148–152. Dostupné z DOI: <http://dx.doi.org/10.1097/MED.0b013e3283444ba0>.
12. Kalyani R, Egan J. Diabetes and Altered Glucose Metabolism with Aging. Endocrinol Metab Clin North Am 2013; 42(2): 333–347. Dostupné z DOI: <http://dx.doi.org/10.1016/j.ecl.2013.02.010>.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
2016 Issue Suppl 4
Most read in this issue
- Congenital hyperinsulinism: Loss of B-cell self-control
- Gestational Diabetes Mellitus
- Growth hormone, axis GH-IGF1 and glucose metabolism
- Education of a patient with diabetes – an integral part of complex therapy