Management of Type 2 Diabetes Mellitus in the Elderly

Soo-Kyung Kim

doi:10.4093/jkd.2018.19.4.200

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Kim: Management of Type 2 Diabetes Mellitus in the Elderly

Statement

The Journal of Korean Diabetes 2018; 19(4): 200-207.

Published online: 28 December 2018

DOI: https://doi.org/10.4093/jkd.2018.19.4.200

Management of Type 2 Diabetes Mellitus in the Elderly

Soo-Kyung Kim

Department of Endocrinology and Metabolism, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

Corresponding author: Soo-Kyung Kim. Department of Endocrinology and Metabolism, CHA Bundang Medical Center, CHA University School of Medicine, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea, imdrksk@chollian.net

Received 6 October 2018 Accepted 24 October 2018

Korean Diabetes Association

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In Korea, by 2060, the proportion of the elderly population will be 40.1%, and at least one in three persons will have diabetes. Elderly patients with diabetes mellitus have higher rates of premature death, functional disability, and coexisting illnesses such as atherosclerotic cardiovascular disease than those without diabetes. In addition, the risk of geriatric syndrome, such as depression, cognitive dysfunction, urinary incontinence, falls, pain, and polypharmacy, is much higher in those with diabetes. The functional status of each elderly person varies greatly, such that comprehensive geriatric assessments for medical, psychological, functional, and social domains are needed. The goals and methods of diabetes management should be individualized according to the results of these assessments. In the treatment of vulnerable elderly patients with diabetes, hypoglycemia or overtreatment should be avoided.

Keywords: Diabetes mellitus, Elderly, Geriatric assessment

Figures and Tables

Fig. 1

Relationship between diabetes-related risk factors and geriatric syndrome in older people with diabetes.

^*Chronic kidney disease, congestive heart failure, cardiovascular disease, stroke, etc.

Fig. 2

Functional categories of older people with diabetes and the focuse of treatment.

Table 1

Comparison of recommendations for HbA1c targets in older people with type 2 diabetes mellitus

ADL, activities of daily living; LTC, long-term care.

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