Management of Type 2 Diabetes Mellitus in Older Adults

Kim, Kyung Soo; Sung, Kyung Mi; Cho, Yong Wook; Park, Seok Won

doi:10.4093/dmj.2012.36.5.336

Cited by 73 publications

(65 citation statements)

References 48 publications

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“…Falls are a major concern for elderly adults with DM [7]. The high prevalence of falls in ambulatory elderly individuals with DM is well established with reported annual incidence rates of 39% in those over 65 years [6] and 35% in those over 55 years [8].…”

Section: Association Between Diabetes and Fallsmentioning

confidence: 99%

A Growing Troubling Triad: Diabetes, Aging, and Falls

Crews

Yalla

Fleischer

et al. 2013

Journal of Aging Research

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There is a significant and troubling link between diabetes (DM) and falls in the elderly. Individuals with DM are prone to fall for reasons such as decreased sensorimotor function, musculoskeletal/neuromuscular deficits, foot and body pain, pharmacological complications, and specialty (offloading) footwear devices. Additionally, there is some concern that DM patients are prone to have more severe problems with falls than non-DM individuals. Fractures, poorer rehabilitation, and increased number of falls are all concerns. Fortunately, efforts to mitigate falls by DM patients show promise. A number of studies have shown that balance, strength, and gait training may be utilized to successfully reduce fall risk in this population. Furthermore, new technologies such as virtual reality proprioceptive training may be able to provide this reduced risk within a safe training environment.

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Section: Association Between Diabetes and Fallsmentioning

confidence: 99%

A Growing Troubling Triad: Diabetes, Aging, and Falls

Crews

Yalla

Fleischer

et al. 2013

Journal of Aging Research

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show abstract

“…These geriatric conditions should be referred to as a third category of diabetic complications [58] and include cognitive impairment and dementia [55,59-67], depression [68,69], reduced muscle strength and quality [70-72], disability [73-77], falls and fall-related morbidity [78,79], as well as urinary incontinence [80]. These clinical conditions are very frequent in older diabetic people, especially in the frail ones.…”

Section: Methodsmentioning

confidence: 99%

“…However, the gastrointestinal adverse effects (i.e. abdominal bloating, flatulence, and diarrhea), frequent dosing, and relatively high costs [58] represent a limitation for the use of AGIs in geriatric patients…”

Section: Methodsmentioning

confidence: 99%

“…According to the DWPOP guidelines, DPP4-I should be considered as an add-on therapy to metformin when the use of a SU poses an unacceptable risk of hypoglycemia (evidence level 1+; grade of recommendation A) [15]. The potential benefits of DPP-4 in the elderly have been discussed in a number of reviews [2,58,169,175-177]. However, ad hoc studies to establish clinical efficacy of DPP4-I in elderly T2DM patients have been only recently performed.…”

Section: Methodsmentioning

confidence: 99%

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Optimal therapy of type 2 diabetes: a controversial challenge

Dardano

Penno

Prato

et al. 2014

Aging

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Type 2 diabetes mellitus (T2DM) is one of the most common chronic disorders in older adults and the number of elderly diabetic subjects is growing worldwide. Nonetheless, the diagnosis of T2DM in elderly population is often missed or delayed until an acute metabolic emergency occurs. Accumulating evidence suggests that both aging and environmental factors contribute to the high prevalence of diabetes in the elderly. Clinical management of T2DM in elderly subjects presents unique challenges because of the multifaceted geriatric scenario. Diabetes significantly lowers the chances of “successful” aging, notably it increases functional limitations and impairs quality of life. In this regard, older diabetic patients have a high burden of comorbidities, diabetes-related complications, physical disability, cognitive impairment and malnutrition, and they are more susceptible to the complications of dysglycemia and polypharmacy. Several national and international organizations have delivered guidelines to implement optimal therapy in older diabetic patients based on individualized treatment goals. This means appreciation of the heterogeneity of the disease as generated by life expectancy, functional reserve, social support, as well as personal preference. This paper will review current treatments for achieving glycemic targets in elderly diabetic patients, and discuss the potential role of emerging treatments in this patient population.

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“…The number of elderly with diabetes is rapidly increasing worldwide due to increased expectancy (Kim et al, 2012). Diabetes in older adults exhibits a number of characteristics that are different from general cases, including higher and unmanageable postprandial blood glucose.…”

Section: Introductionmentioning

confidence: 99%

Effects of rehabilitation management on gastric emptying function in older adults with diabetes

et al. 2014

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ABSTRACT.The relationship between gastric emptying dysfunction and blood glucose concentration in elderly with type 2 diabetes mellitus was investigated, and the effect of rehabilitation exercise prescription training on gastric emptying in the geriatric diabetic patients was evaluated. A total of 160 older type 2 diabetic adults and 30 cases of non-diabetic patients were studied with regard to the gastric half emptying time (GET1/2) of solid meals radiolabelled with 99mTc. significant differences from non-diabetic patients (P > 0.05). However, the value for poor blood glycemic control patients exhibited significant statistical differences compared with both non-diabetic (P < 0.01) and regulated blood glycemic control group patients (P < 0.01). It showed that the gastric emptying time improved in the rehabilitation exercise group, mosapride group and rehabilitation exercise group + mosapride group after two years of treatment (P < 0.05). Fasting blood glucose in both rehabilitation exercise group and rehabilitation exercise + mosapride group was significantly decreased. Postprandial blood glucose in the rehabilitation exercise group, mosapride group, rehabilitation exercise group + mosapride group was significantly decreased. High blood glucose level can delay gastric emptying in older type 2 diabetic patients. Gastric emptying and blood glucose control affect each other. It was shown that appropriate rehabilitation exercise combined with prokinetic agent may improve gastric emptying in some geriatric type 2 diabetic patients and help control their blood glucose.

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Management of Type 2 Diabetes Mellitus in Older Adults

Cited by 73 publications

References 48 publications

A Growing Troubling Triad: Diabetes, Aging, and Falls

A Growing Troubling Triad: Diabetes, Aging, and Falls

Optimal therapy of type 2 diabetes: a controversial challenge

Effects of rehabilitation management on gastric emptying function in older adults with diabetes

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