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Innere Medizin up2date 2014; 2(02): 103-114
DOI: 10.1055/s-0034-1370120
Innere Medizin im Alter
© Georg Thieme Verlag KG Stuttgart · New York

Geriatrische Aspekte des Diabetes

Ann-Kathrin Meyer
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Publication History

Publication Date:
17 June 2014 (online)

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See also:

Geriatrische Aspekte des DiabetesDiabetologie und Stoffwechsel 2010; 5(05): R65-R74
DOI: 10.1055/s-0030-1262590

Kernaussagen

  • Angepasst an das individuelle Patientenrisikoprofil sollte der Leitsatz der Geriatrie: „Start low and go slow – but go far enough“ praktiziert werden. Mit diesem Therapieansatz und dem ärztlichen Mut zur Vereinfachung komplexer Therapieverfahren sowie Priorisierung einer moderaten Stoffwechselkontrolle, lassen sich die meisten Komplikationen vermeiden bzw. rechtzeitig reduzieren.

  • Die sichere Handhabbarkeit der Therapie im Alltag, die Berücksichtigung möglicher Einschränkungen durch alterstypische Multimorbidität und die Vermeidung von Hypoglykämien dienen dem übergeordneten Ziel der Erhalt der Lebensqualität im Alter.

 

  • Literatur

  • 1 Heidemann C, Du Y, Schubert I et al. Prevalence and temporal trend of known diabetes mellitus: results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsbl Gesundheitsfor Gesundheitssch 2013; 56: 668-677
    Google Scholar
  • 2 Rathmann W, Haastert B, Icks A et al. High prevalence of undiagnosed diabetes mellitus in Southern Germany: Target populations for efficient screening. The KORA survey 2000. Diabetologia 2003; 46: 182-189
    CrossrefPubMedGoogle Scholar
  • 3 Nikolaus T, Kruse W, Bach M et al. Elderly patientsʼ problems with medication. An inhospital and follow-up study. Eur J Clin Pharmacol 1996; 49: 255-259
    CrossrefGoogle Scholar
  • 4 Bach M. Arbeitsgruppe Geriatrisches Assessment Hrsg. (Red.). Geriatrisches Basisassessment, Handlungsanleitung für die Praxis.
    Google Scholar
  • 5 Budnitz DS, Lovegrove MC, Shehab N et al. Emergency Hospitalizations for Adverse Drug Events in Older Americans. N Engl J Med 2011; 365: 2002-2012
    CrossrefPubMedGoogle Scholar
  • 6 Dale A, Vatten LJ, Nilsen TI et al. Secular decline in mortality from coronary heart disease in adults with diabetes mellitus: cohort study. BMJ 2008; 337: a236-a236
    CrossrefGoogle Scholar
  • 7 Zeyfang A. Structured educational programs for geriatric patients with diabetes mellitus. MMW Fortschr Med 2005; 147: 45-46
    Google Scholar
  • 8 Rizzo MR, Paolisso G et al. Relationships Between Daily Acute Glucose Fluctuations and Cognitive Performance Among Aged Type 2 Diabetic Patients. Diabetes CARE 2010; 33: 2169-2174
    CrossrefGoogle Scholar
  • 9 Bruce DG, Davis WA, Casey GP et al. Severe hypoglycaemia and cognitive impairment in older patients with diabetes: the Fremantle Diabetes Study. Diabetologia 2009; 52: 1808-1815
    CrossrefPubMedGoogle Scholar
  • 10 Whitmer RA, Karter AJ, Yaffe K et al. Hypoglycemic episodes and risk of dementia in older patients with type2 diabetes mellitus. JAMA 2009; 301: 1565-1572
    CrossrefGoogle Scholar
  • 11 Crane PK et al. Glucose Levels and Risk of Dementia. N Engl J Med 2013; 369: 540-548
    CrossrefGoogle Scholar
  • 12 Holman RR, Paul SK, Bethel MA et al. 10-year fallow-up of intensive glucose control in type2 diabetes. N Engl J Med 2008; 359: 1577-1589
    CrossrefGoogle Scholar
  • 13 Garber A, Duncan TG, Goodman AM et al. Efficacy of metformin in typeII diabetes: results of a double-blind, placebo-controlled, dose response trial. Am J Med 1997; 103: 491-497
    CrossrefPubMedGoogle Scholar
  • 14 Scirica BM, Itamar R et al. Saxagliptin and Cardiovascular Outcomes in Patients with Type 2 Diabetes mellitus. N Engl J Med 2013; 369: 1317-1326
    CrossrefGoogle Scholar
  • 15 White WB et al. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N Engl J Med 2013; 369: 1327-1335
    CrossrefGoogle Scholar
  • 16 Bailey CJ et al. Effect of dapagliflozin in patients with type 2 diabetes who have inadequate glycaemic control with metformin: a randomised, double-blind, placebo-controlled trial. Lancet 2010; 375: 2223-2233
    CrossrefGoogle Scholar
  • 17 Roumie CL, Hung AM et al. Comparative effectiveness of sulfonylurea and metformin monotherapy on cardiovascular events in type 2 diabetes mellitus: a cohort study. Ann Intern Med 2012; 157: 601-610
    CrossrefGoogle Scholar
  • 18 Yki-Järvinen H. Drug Therapy Thiazolidinediones. N Engl J Med 2004; 351: 1106-1118
    CrossrefGoogle Scholar
  • 19 Nauck MA, Duran S, Kim D et al. A comparsion of twice daily exenatide and biphasic insulin aspart in patients with type2 diabetes who were suboptimally controlled with sulfonylurea and metformin: a non-inferiority study. Diabetologia 2007; 50: 259-267
    CrossrefGoogle Scholar
  • 20 The ACCORD Study Group (Action to Control Cardiovascular Risk in Diabetes Study Group). Effects of intensive glucose lowering in type2 diabetes. N Engl J Med 2008; 358: 2545-2559
    CrossrefGoogle Scholar
  • 21 The ADVANCE Collaborative Group. Intensive blood glucose control and vascular outcomes in patients with type2 diabetes. N Engl J Med 2008; 358: 2560-2572
    CrossrefGoogle Scholar
  • 22 Duckworth W, Abraira C, Moritz T et al. Glucose control and vascular complications in veterans with type2 diabetes. N Engl J Med 2009; 360: 129-139
    CrossrefPubMedGoogle Scholar
  • 23 Jehle PM, Micheler C, Jehle DR et al. Inadequate suspension of neutral protamine hagendorn (NPH) insulin in pens. Lancet 1999; 354: 1604-1607
    CrossrefPubMedGoogle Scholar