Treatment of type 2 diabetes mellitus in the elderly

Abstract

The prevalence of type 2 diabetes is expected to increase gradually with the prolongation of population aging and life expectancy. In addition to macrovascular and microvascular complications of elderly patients of diabetes mellitus, geriatric syndromes such as cognitive impairment, depression, urinary incontinence, falling and polypharmacy are also accompanied by aging. Individual functional status in the elderly shows heterogeneity so that in these patients, there are many unanswered questions about the management of diabetes treatment. The goals of diabetes treatment in elderly patients include hyperglycemia and risk factors, as in younger patients. comorbid diseases and functional limitations of individuals should be taken into consideration when setting treatment targets. Thus, treatment should be individualized. In the treatment of diabetes in vulnerable elderly patients, hypoglycemia, hypotension, and drug interactions due to multiple drug use should be avoided. Since it also affects the ability to self-care in these patients, management of other concurrent medical conditions is also important.

Usability Issues of Clinical and Research Applications of Virtual Reality in Older People: A Systematic Review

“…In addition, aging hampers psychosocial well-being by adding new developmental tasks or situations (e.g., isolation; Steptoe et al, 2015). In particular, the prevalence of Alzheimer's disease, cancer, chronic obstructive pulmonary disease, maculopathy, osteoarthritis, osteopenia, Parkinson's disease, periodontitis, rheumatoid arthritis, sarcopenia, cardiovascular diseases, and type 2 diabetes increases with age (Tolosa et al, 2006;Dubois et al, 2010;Marengoni et al, 2011;Edwards et al, 2015;Steenman and Lande, 2017;Yakaryilmaz and Öztürk, 2017;Franceschi et al, 2018). Additionally, several clinical conditions may jeopardize the well-being of older people, such as mild cognitive impairment, frailty, or metabolic syndrome (Fried et al, 2001;Petersen, 2004;Portet et al, 2006;Huang, 2009;Xue, 2011;Fedarko, 2012).…”

Prevalence and factors associated with type 2 diabetes mellitus and hypertension among the hill tribe elderly populations in northern Thailand

“…There are different factors associated with T2DM and HT in different populations, particularly among those with different lifestyles and cultures [3, 4]. Older populations are the most vulnerable to the development of T2DM and HT [5, 6]. T2DM and HT have become major causes of morbidity and mortality of elderly populations in all countries [7, 8].…”

Type 2 diabetes mellitus in elderly patients treated with endocrinologists in clinical practice

“…При этом у пожилых пациентов с СД2 смертность в два раза выше, чем среди пожилых людей без диабета [5]. На фоне назначения терапии как СД2, так и коморбидной патологии формируется проблема полипрагмазии [6].…”

“…СД2 в пожилом возрасте ассоциирован не только с увеличением количества заболеваний, чаще хронического течения, но и с развитием ряда гериатрических синдромов, которые следует учитывать при назначении сахароснижающей терапии [6][7][8][9][10] (табл. 2).…”

“…Важно подчеркнуть, что когнитивная дисфункция является фактором низкой приверженности к любой терапии больного (в том числе сахароснижающей), ухудшения гликемического контроля, что, безусловно, требует более простой схемы лечения заболевания. Рациональная, безопасная в отно-шении гипогликемий сахароснижающая терапия замедляет процесс развития когнитивной дисфункции [6,7]. До 25-35% больных СД2 в пожилом возрасте страдают эпизодами депрессии, что значительно выше, чем в общей популяции.…”