Trends in the quality of care for elderly people with type 2 diabetes: The need for improvements in safety and quality (the 2001 and 2007 ENTRED Surveys)

Pornet, Carole; Bourdel-Marchasson, I.; Lecomte, P.; Eschwège, É.; Romon, I.; Fosse, S.; Assogba, F.; Roudier, Candice; Fagot-Campagna, A.

doi:10.1016/j.diabet.2011.02.001

Cited by 60 publications

(32 citation statements)

References 31 publications

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“…Its prevalence increases sharply after middle age to reach 14.2% in patients aged 65 and over [2], and 75-yearolds account for 25% of diabetic patients [3]. The figures in France are consistent with the European average [4].…”

Section: Introductionsupporting

confidence: 73%

“…The complications of diabetes are most frequent in the elderly and increase with age [2]: 45.3% of patients aged 65-74 experience vascular complications and this figure rises to 62.2% among patients aged 85 and over. Moreover, elderly diabetic patients are at a greater risk of developing other complications such as malnutrition, dementia, falls, fracture, depression and incontinence [9].…”

Section: Introductionmentioning

confidence: 96%

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Primary care management of non-institutionalized elderly diabetic patients: The S.AGES cohort – Baseline data

Bucher

Bauduceau

Benattar-Zibi³

et al. 2015

Primary Care Diabetes

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Section: Introductionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 96%

Primary care management of non-institutionalized elderly diabetic patients: The S.AGES cohort – Baseline data

Bucher

Bauduceau

Benattar-Zibi³

et al. 2015

Primary Care Diabetes

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“…15 Kidney function also tends to decrease with age, so elderly patients may have moderate RI as a result of age-related decline in glomerular filtration rate (GFR), even in the absence of major contribution from advanced diabetic disease or other specific pathology. 16 In the large-scale Échantillon National Témoin Représentatif des Personnes Diabétiques (ENTRED) survey of diabetic patients in France, 17 mean estimated GFR (eGFR) decreased with age and 28% of the population of patients with T2DM aged $ 65 years had an eGFR of , 60 mL/min/1.73 m 2 ; this proportion clearly increased with age (up to 37% of patients aged 75-79 years). 17 Renal impairment may often go undetected.…”

Section: Importance Of Ri In the Diabetic Populationmentioning

confidence: 99%

Incretin Therapies in the Management of Patients with Type 2 Diabetes Mellitus and Renal Impairment

Dejager

Schweizer

2012

Hospital Practice

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Renal impairment (RI) is common among patients with type 2 diabetes mellitus (T2DM), and these patients also experience an age-related decline in renal function. At the same time, treatment options are more limited and treatment is more complex, particularly in patients with moderate or severe RI due to contraindications, need for dose adjustment and/or regular monitoring, and side effects, such as fluid retention and hypoglycemia, which are a more serious concern in this patient population. Incretin therapies, consisting of the injectable glucagon-like peptide-1 (GLP-1) receptor agonists and the oral dipeptidyl peptidase-4 (DPP-4) inhibitors, are a promising new class of antihyperglycemic drugs. In the overall population, they improve glycemic control in a glucose-dependent manner and are not likely to cause hypoglycemia, representing a clear advantage in at-risk populations. Data regarding use of these agents in renally impaired patients have started to emerge, and the objective of this article is to provide an overview of the currently available data and the potential role of these novel agents in the management of patients with T2DM and RI. Data for the GLP-1 receptor agonists in patients with moderate or severe RI are still limited, with no trials dedicated to these populations currently published. In addition, their potential to cause gastrointestinal side effects may limit use in patients with RI due to the risk of dehydration and hypovolemia. The use of GLP-1 receptor agonists in patients with moderate or severe RI is therefore, at present, underlying caution and/or restrictions. On the other hand, data from specific trials in patients with moderate or severe RI are now becoming available for most of the DPP-4 inhibitors. These studies demonstrate good efficacy and tolerability of the DPP-4 inhibitors in patients with moderate or severe RI, thus opening a place for these therapies in the treatment of populations with T2DM and RI. Several of the DPP-4 inhibitors are already approved for use in patients with moderate or severe RI, including for those with end-stage renal disease. While discussing the advantages related to their common mechanism of action, this article also describes differences among the DPP-4 inhibitors (eg, related to their pharmacokinetic properties and the available clinical data). In conclusion, while initial data for these new therapies are promising, further experience is needed to fully assess the risk-benefit balance and clinical positioning of these agents in RI populations.

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“…Si des progrès notables ont été enregistrés entre 2001 et 2007 dans les études ENTRED, de nombreux points demeurent perfectibles [30].…”

Section: -Traitementunclassified

Management of Diabetes in Elderly

Bauduceau

Bordier

2017

IJMS

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RESUMELa prise en charge des patients diabétiques âgés est devenue aujourd'hui un véritable problème de santé publique du fait de l'augmentation du nombre des malades. Dans cette population, les complications du diabète sont plus graves et s'intriquent avec les manifestations plus spécifiquement gérontologiques. L'évaluation gériatrique standardisée est indispensable pour définir la situation de chaque malade selon son degré d'autonomie et de dénutrition, ses fonctions cognitives et son environnement social. Les objectifs thérapeutiques doivent être individualisés en fonction de la présentation clinique du patient. L'insulinothérapie est fréquemment incontournable et nécessite l'éducation du patient ou de son entourage. La prise en charge des patients diabétiques âgés doit éviter un trop grand laxisme chez une personne restée en bonne santé mais aussi un activisme déraisonnable chez les sujets fragiles en raison du risque hypoglycémique. MOTS CLÉS :Diabète, Sujet Agé, Complications, Insuline, Hypoglycémie. ABSTRACTThe management of elderly diabetic patients has become a real public health problem due to the increase in the number of patients. In this population, the complications of diabetes are more serious and are associated with manifestations more specifically gerontological. The standardized geriatric assessment is essential to define the situation of each patient according to his degree of autonomy and undernutrition, his cognitive functions and his social environment. The therapeutic objectives must be individualized according to the clinical status of the patient. Insulin therapy is often unavoidable and requires a good education of the patient or his family. The management of diabetes in elderly patients must also avoid too much laxity in a person who is remained healthy but also an unreasonable activism in the fragile subjects due to the hypoglycemic risk.

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Trends in the quality of care for elderly people with type 2 diabetes: The need for improvements in safety and quality (the 2001 and 2007 ENTRED Surveys)

Cited by 60 publications

References 31 publications

Primary care management of non-institutionalized elderly diabetic patients: The S.AGES cohort – Baseline data

Primary care management of non-institutionalized elderly diabetic patients: The S.AGES cohort – Baseline data

Incretin Therapies in the Management of Patients with Type 2 Diabetes Mellitus and Renal Impairment

Management of Diabetes in Elderly

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