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For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
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Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
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Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
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The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
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[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.

Zeitschrift Fur Gerontologie Und Geriatrie
|November 26, 2020
PubMed
Summary

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.

Keywords:
COVID-19Diabetes technologyDrug therapyGeriatric assessmentHypoglycemia

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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.