Interní Med. 2012; 14(8-9): 303-308

Specific features of treatment of diabetes in the elderly

prof.MUDr.Jaroslav Rybka, DrSc.

Diabetologické centrum IK IPVZ, Krajská nemocnice T. Bati, a. s., Zlín

Diabetes mellitus is the most significant metabolic disease in older age. The course of diabetes and its manifestations, however, are

frequently different in comparison with those in the middle age. The current Czech Diabetes Society (CDS) guidelines are used in the

treatment of diabetes in older age. Emphasis is placed on individualization of treatment that has to be adapted to the health condition

of the elderly patient, particularly in the case of comorbidities. Even in elderly patients with diabetes, achieving glycemic control is

a cornerstone of the therapeutic strategy; however, in elderly diabetics, circumstances need to be taken into account that may result in

a further narrowing of the range within which it is still possible to maintain homeostasis. Prior to initiating therapy, patients are always

evaluated, in addition to comorbidities and diabetic complications, for possible cardiovascular damage, kidney disease, and liver disease.

Based on this, the treatment algorithm, the choice of an antidiabetic agent, and the dosage are adjusted. Also, in elderly patients with

unsatisfactory T2DM control, switching to insulin should in no way be delayed inappropriately. During the treatment, it is necessary

to carefully follow the contraindications of the antidiabetic agents used and to try to avoid the risk of developing hypoglycemia that is

a very serious condition in elderly patients.

Keywords: diabetes mellitus, elderly type 2 diabetics, nonpharmacological measures, oral antidiabetic agents, multimorbidity, specific features of treatment, measures in kidney and liver injury

Published: September 20, 2012  Show citation