Diabetes mellitus involves long-term complications that affect diabetic patients' quality of life. The best way to prevent these complications is that patients achieve good metabolic control. In order to reach this goal, patients are requested to acquire daily behaviours (self-care). Such behaviours are sometimes hard to adhere, because they require changes in habits acquired over time. The aim of the present study is to evaluate the improvement on self-care after a pharmaceutical intervention on home regime patients. We performed a controlled experimental comparative study with a follow up of 6 months, on 87 patients, randomized in control group (n=43) and intervention group (n=44). We accessed sociodemographic and clinical data (glycaemic profile), as well as adherence to drug therapy and self-assessed care (before/after). In the intervention group, mean age was 74.2±5.4 years, and the median time of T2DM diagnosis was 14.7±8.5 years. At the end of study, the decrease in fasting blood glucose was higher in the intervention group patients than that observed in the control group (50.2mg/dL), with statistically significant difference (p<0.05), as well as the decrease verified in HbA1c. In self-care adherence, alterations in the levels of adherence of the general nutrition and physical exercise dimensions became evident, with an increase in the number of days of adherence. On medication adherence statistically significant alterations (p<0.05) were also recorded. We can conclude that an individualized pharmaceutical intervention can improve self-care behaviours, as well as medication adherence, contributing to better metabolic control.

The present document describes a nutritional approach that is nested in the European Innovation Partnership for Active and Healthy Aging (EIP-AHA) and aims to provide the first common European program translating an integrated approach to nutritional frailty in terms of a multidimensional and transnational methodology. The document has been developed by the A3 Nutrition Action Area of the EIP-AHA and aims at providing a stepwise approach to malnutrition in older citizens, identifying adequate interventions based on a unified assessment and ICT-supported solutions. “NutriLive” is an integrated nutritional approach, represented by a structured Screening-Assessment-Monitoring-Action-Pyramid-Model (SAM-AP). Its core concept is the stratification of the nutritional needs, considered by the working group as the key for targeted, effective, and sustainable interventions. “NutriLive” tries to close gaps in epidemiological data within an aging population, creating a unified language to deal with the topic of nutrition and malnutrition in Europe. By assembling all the validated screening, assessment, and monitoring tools on malnutrition in a first pyramid, which is interrelated to a second intervention pyramid, the A3 Nutrition WG identifies a common, integrated vision on the nutritional approach to frailty, which applies to the various health care settings.

Diabetic Peripheral Neuropathy (DPN) is highly prevalent among diabetic ageing adults. The sensory and motor impairments caused by this long-term complication lead to poorer physical functioning, postural control and balance. These changes affect the activities of daily living and increase the risk of falling, subsequently leading to increased morbidity and decreased quality of life. Early detection of such functional limitations is important, as it may influence the effectiveness of rehabilitation programs and prevent further functional dependence. This review focuses on functional aspects related to balance, postural control and mobility in ageing adults suffering from DPN, as well as their assessment by valid, reliable and low-cost performance-based measurements. PUBMED was searched for articles in English published between 2004 and 2014. Search terms included diabetic neuropathy, balance, postural control, functional mobility, and functional outcomes. Reviewed literature indicates that simple and low-cost measurements, easy to include in clinical routines, can be used for screening impairments in complex functions, such as balance and mobility. Some studies have also been able to correlate results from DPN severity scales with those of functional tests, showing that applying such tests may improve the early diagnosis of this neurological disorder. Berg Balance Scale, Dynamic Gait Index, Functional Reach Test, and Time Up and Go already have modified cut-off points for the Diabetes Mellitus older population, but need validation for ageing adults with DPN. Further research on this subject should be addressed, in order to improve assessment outcomes.

The prevalence of diabetes increases with age, which is also a determinant of nutrition therapy adherence. This descriptive study was conducted in a non-random sample of 66 patients aged between 47 and 75 years (M=61.5; SD=8.0) receiving health care in a Diabetes Clinic in the municipality of Faro, in the Portuguese region of the Algarve. We aimed to assess the association between age and the clinical characteristics of type 2 diabetes and to analyze the perceptions regarding the barriers to an adequate diet. Glycated hemoglobin (HbA1c) (r=-0.372, P<0.001) showed a negative correlation with age, suggesting that older patients have a better glucose control. Older age is also correlated with a higher number of daily meals (r=0.263) and lower intake of energy (r=-0.334), protein (r=-0.249), sugars (r=-0.301), and water (r=-0.223). Forty-six patients (69.7%) had a mean excess energy intake of 384 kcal (SD=630.2), when compared with individual nutritional energy estimated requirements. Excess energy intake was uncorrelated with age (r=-0.138, P=0.269). Older patients also seem more confused with the nutrition information they received (r=0.248) and feel that they need more advice on what is a proper diet (r=0.242). Nutrition education interventions in this population must be tailored in order to address these factors.

Introduction: A significant number of individuals are dissatisfied with their body size and weight, and wish to be thinner. Some of the physical changes associated with aging do not inevitably lead to greater body dissatisfaction but there is evidence suggesting that the importance and concerns attached to appearance and body image may be similar in all ages. This study aimed at analysing body image perceptions, body image satisfaction, and body mass index in older adults.