REVIEW OF THE COURSE AND TREATMENT OF DIABETES MELLITUS IN THE ELDERLY
Keywords:
diabetes mellitus, features, course, diagnostics, elderly, treatmentAbstract
Diabetes mellitus (DM) is becoming one of the most common problems among older people [5,8]. The prevalence of DM worldwide among people aged 65 years and older was 123 million in 2017 [2,6,12], and the number of such patients is expected to double in 2045. Over the past three decades, age-standardized prevalence of the disease has increased significantly in various countries, regardless of income level. According to experts, up to 40% of this increase is due to population growth and aging [1,3,9,15]. Diabetes mellitus is one of the most common health problems in older people, who form a heterogeneous and complex group, because it includes newly diagnosed elderly patients with DM and patients with a long course of the disease, onset in middle or young age [4,7,11]. This creates challenges for clinicians in the management of diabetes due to difficulties in defining individual glucose control goals, treatment options, comorbidities, multiple medications, and the risk of hypoglycemia. The objective of this review article is to consider the optimal glucose levels and treatment options for older adults with type II diabetes based on current global guidelines.
References
American Diabetes Association. Older Adults: Standards of Medical Care in Diabetes—2019. Diabetes Care 2019 Jan; 42(Supplement 1): S139-S147. doi: 10.2337/dc19-S012. Vol. 15, No. 6, 2019 http://iej.zaslavsky.com.ua 499 /Literature Review/
Diabetes in old age / ed. By A.J. Sinclair and P. Finucane. – 2nd ed., J.Wiley & Sons Ltd. 2001.
Drouin P. Diabet Complicat 2000; 14: 185–92.
Huang CC, Weng SF, Tsai KT, et al. Long-term Mortality Risk After Hyperglycemic Crisis Episodes in Geriatric Patients With Diabetes: A National Population-Based Cohort Study. Diabetes Care. 2015 May;38(5):746-51. doi: 10.2337/dc14-1840.
International Diabetes Federation. IDF Diabetes Atlas. 8th Ed. 2017. Available from: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/134-idf-diabetes-atlas-8th-edition.html.
Kalyani RR, Golden SH, Cefalu WT. Diabetes and Aging: Unique Considerations and Goals of Care. Diabetes Care. 2017 Apr;40(4):440-443. doi: 10.2337/dci17-0005.
LeRoith D, Biessels GJ, Braithwaite SS, et al. Treatment of diabetes in older adults: an endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2019 May 1;104(5):1520-1574. doi: 10.1210/jc.2019-00198.
Longo M, Bellastella G, Maiorino MI, Meier JJ, Esposito K, Giugliano D. Diabetes and Aging: From Treatment Goals to Pharmacologic Therapy. Front Endocrinol (Lausanne). 2019 Feb 18;10:45. doi: 10.3389/fendo.2019.00045.
Menke A, Casagrande S, Geiss L, Cowie CC. Prevalence of and Trends in Diabetes Among Adults in the United States, 1988-2012. JAMA. 2015 Sep 8;314(10):1021-9. doi: 10.1001/jama.2015.10029.
Palta P, Huang ES, Kalyani RR, Golden SH, Yeh HC. Hemoglobin A1c and Mortality in Older Adults With and Without Diabetes: Results From the National Health and Nutrition Examination Surveys (1988-2011). Diabetes Care. 2017 Apr;40(4):453-460. doi: 10.2337/ dci16-0042.
Pedersen BK, Febbraio MA. Muscle as an endocrine organ: focus on muscle-derived interleukin-6. Physiol Rev. 2008 Oct;88(4):1379-406. doi: 10.1152/physrev.90100.2007.
Roglic G. WHO Global report on diabetes: A summary. Int J Non-Commun Dis. 2016;1(1):3-8.
Tchkonia T, Kirkland JL. Aging, Cell Senescence, and Chronic Disease: Emerging Therapeutic Strategies. JAMA. 2018 Oct 2;320(13):1319-1320. doi: 10.1001/jama.2018.12440.
Tchkonia T, Morbeck DE, Von Zglinicki T, et al. Fat tissue, aging, and cellular senescence. Aging Cell. 2010 Oct;9(5):667-84. doi: 10.1111/j.1474 9726.2010.00608.x.
The population of Belarus is aging faster than the population of the world as a whole. Available from: https://www.belta.by/society/ view/naselenie-belarusi-stareet-bystree-chem-naselenie-mira-v-tselom-96430-2012. Accessed: Apr 2012. (in Russian).
