[Diabetes mellitus in old age]
Andrej Zeyfang1,2, Joachim Zeeh3, Anke Bahrmann4
1Klinik für Innere Medizin, Altersmedizin, Diabetologie und Palliativmedizin, medius KLINIK OSTFILDERN-RUIT, Hedelfinger Str. 166, 73760, Ostfildern, Deutschland. a.zeyfang@medius-kliniken.de.
Treating diabetes in older adults requires a holistic approach, focusing on quality of life and symptom relief over strict HbA1c goals. Geriatric assessment guides personalized strategies for multimorbid patients, prioritizing safety and well-being.
Area of Science:
- Geriatrics
- Endocrinology
- Public Health
Background:
- Diabetes management in the elderly requires individualized care beyond glycemic control.
- Older adults with diabetes are a vulnerable population, particularly concerning for severe COVID-19 outcomes.
- Multimorbidity and age-related changes significantly impact treatment efficacy and safety.
Purpose of the Study:
- To emphasize a patient-centered approach in geriatric diabetes care.
- To highlight the importance of geriatric assessment in treatment strategy development.
- To outline key considerations for pharmacotherapy in elderly diabetic patients.
Main Methods:
- Utilizing geriatric assessment to evaluate functional, psychological, and cognitive status.
- Individualizing treatment goals based on patient resources and quality of life.
- Carefully considering renal function, hydration, and dose titration in medication management.
Main Results:
- Glycated hemoglobin (HbA1c) targets are secondary to symptom management and quality of life.
- Geriatric assessment provides crucial data for tailoring diabetes treatment plans.
- Specific precautions are necessary regarding renal insufficiency, dehydration, and slow dose adjustments.
Conclusions:
- Diabetes treatment in the elderly necessitates a comprehensive assessment of the individual's resources.
- Prioritizing symptom freedom, hypoglycemia avoidance, and quality of life is paramount.
- Older adults with diabetes, especially those with comorbidities like hypertension and cardiovascular disease, face elevated risks for severe COVID-19.
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