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Wiener klinische Wochenschrift

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12.04.2019 | Insuline | leitlinien für die praxis

Geriatrische Aspekte bei Diabetes mellitus (Update 2019)

verfasst von: Joakim Huber, Michael Smeikal, Christoph H. Saely, Harald Stingl, Monika Lechleitner, Peter Fasching

Erschienen in: Wiener klinische Wochenschrift | Sonderheft 1/2019

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Zusammenfassung

Es besteht eine hohe Prävalenz an Diabetes mellitus Typ 2 bei über 70-Jährigen in industrialisierten Ländern. Dieser Artikel enthält Empfehlungen für Diagnose, Prävention und Therapieziele in der Behandlung des älteren diabetischen Patienten anhand der aktuellen Evidenzlage.

Rathmann W, Haastert B, Icks A, Löwel H, Meisinger C, Holle R, et al. High prevalence of undiagnosed diabetes mellitus in southern Germany: target populations for efficient screening. The KORA survey 2000. Diabetologia. 2003; https://doi.org/10.1007/s00125-002-1025-0.CrossRefPubMed

The DECODE study group. Age- and sex-specific prevalences of diabetes and impaired glucose regulation in 13 European cohorts. Diabetes Care. 2003; https://doi.org/10.2337/diacare.26.1.61.CrossRef

2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2018. Diabetes Care. 2018;41(Suppl 1):S13–S27

Roden M. Diabetes mellitus – Definition, Klassifikation und Diagnose. Wien Klin Wochenschr. 2016;128(Suppl 2):S37–S40.CrossRef

Resnick HE, Harris MI, Brock DB, Harris TB. American Diabetes Association diabetes diagnostic criteria, advancing age, and cardiovascular disease risk profiles: results from the Third National Health and Nutrition Examination Survey. Diabetes Care. 2000. https://doi.org/10.2337/diacare.23.2.176.CrossRefPubMed

Bethel MA, Sloan FA, Belsky D, Feinglos MN. Longitudinal incidence and prevalence of adverse outcomes of diabetes mellitus in elderly patients. Arch Intern Med. 2007. https://doi.org/10.1001/archinte.167.9.921.CrossRefPubMed

Rosenthal MJ, Fajardo M, Gilmore S, Morley JE, Naliboff BD. Hospitalization and mortality of diabetes in older adults: a 3‑year prospective study. Diabetes Care. 1998. https://doi.org/10.2337/diacare.21.2.231.CrossRefPubMed

Tancredi M, Rosengren A, Svensson A‑M, Kosiborod M, Pivodic A, Gudbjörnsdottir S, et al. Excess mortality among persons with type 2 diabetes. N Engl J Med. 2015. https://doi.org/10.1056/NEJMoa1504347.CrossRefPubMed

Diabetes Prevention Program Research Group, Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Diabetes Prevention Program Research Group. Diabetes prevention program research group reduction in the incidence of type 2 diabetes with lifestyle intervention metformin. N Engl J Med. 2002. https://doi.org/10.1016/j.biotechadv.2011.08.021.Secreted.CrossRefPubMedCentral

10.

Jefferis BJ, Lennon L, Whincup PH, Wannamethee SG. Longitudinal associations between changes in physical activity and onset of type 2 diabetes in older British men: the influence of adiposity. Diabetes Care. 2012. https://doi.org/10.2337/dc11-2280.CrossRefPubMedPubMedCentral

11.

Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, et al. Weight loss, exercise, or both and physical function in obese older adults. N Engl J Med. 2011. https://doi.org/10.1056/NEJMoa1008234.CrossRefPubMedPubMedCentral

12.

Meneilly GS, Knip A, Miller DB, Sherifali D, Tessier D, Zahedi A. Diabetes in older people. Can J Diabetes. 2018. https://doi.org/10.1016/j.jcjd.2017.10.021.CrossRefPubMed

13.

Dorner B. Position of the American Dietetic Association: individualized nutrition approaches for older adults in health care communities [corrected] [published erratum appears in J Am Diet Assoc 2010 Dec;110(12):1941. J Am Diet Assoc. 2010. https://doi.org/10.1016/j.jada.2010.08.022.CrossRefPubMed

14.

Volkert D, Bauer J, Frühwald T, Gehrke I, Lechleitner M, Lenzen-Großimlinghaus R, et al. Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) in Zusammenarbeit mit der GESKES, der AKE und der DGG. Aktuel Ernahrungsmed. 2013. https://doi.org/10.1055/s-0033-1343169.CrossRef

15.

Evans WJ. Protein nutrition, exercise and aging. J Am Coll Nutr. 2004. https://doi.org/10.1080/07315724.2004.10719430.CrossRefPubMed

16.

Bandeen-Roche K, Seplaki CL, Huang J, Buta B, Kalyani RR, Varadhan R, et al. Frailty in older adults: a nationally representative profile in the United States. J Gerontol A Biol Sci Med Sci. 2015. https://doi.org/10.1093/gerona/glv133.CrossRefPubMedPubMedCentral

17.

Kalyani RR, Tian J, Xue QL, Walston J, Cappola AR, Fried LP, et al. Hyperglycemia and incidence of frailty and lower extremity mobility limitations in older women. J Am Geriatr Soc. 2012. https://doi.org/10.1111/j.1532-5415.2012.04099.x.CrossRefPubMedPubMedCentral

18.

Bertoni AG, Krop JS, Anderson GF, Brancati FL. Diabetes-related morbidity and mortality in a national sample of U.S. elders. Diabetes Care. 2002. https://doi.org/10.2337/diacare.25.3.471.CrossRefPubMed

19.

Gregg EW, Beckles GLA, Williamson DF, Leveille SG, Langlois JA, Engelgau MM, et al. Diabetes and physical disability among older U.S. adults. Diabetes Care. 2000. https://doi.org/10.2337/diacare.23.9.1272.CrossRefPubMed

20.

Krop JS, Powe NR, Weller WE, Shaffer TJ, Saudek CD, Anderson GF. Patterns of expenditures and use of services among older adults with diabetes: implications for the transition to capitated managed care. Diabetes Care. 1998. https://doi.org/10.2337/diacare.21.5.747.CrossRefPubMed

21.

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001. https://doi.org/10.1093/gerona/56.3.M146.CrossRefPubMed

22.

Sinclair A, Morley J. Frailty and diabetes. Lancet. 2013. https://doi.org/10.1016/S0140-6736(13)61676-1.CrossRefPubMed

23.

Cruz-Jentoft A, Baeyens J, Bauer J, Boirie Y, Cederholm T, Landi F, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010. https://doi.org/10.1093/ageing/afq034.CrossRefPubMedPubMedCentral

24.

Leenders M, Verdijk LB, van der Hoeven L, Adam JJ, van Kranenburg J, Nilwik R, et al. Patients with type 2 diabetes show a greater decline in muscle mass, muscle strength, and functional capacity with aging. J Am Med Dir Assoc. 2013. https://doi.org/10.1016/j.jamda.2013.02.006.CrossRefPubMed

25.

Volpato S, Bianchi L, Lauretani F, Lauretani F, Bandinelli S, Guralnik JM, et al. Role of muscle mass and muscle quality in the association between diabetes and gait speed. Diabetes Care. 2012. https://doi.org/10.1016/j.jamda.2013.02.006.CrossRefPubMedPubMedCentral

26.

Woo J, Leung J, Morley JE. Validating the SARC-F: a suitable community screening tool for sarcopenia? J Am Med Dir Assoc. 2014. https://doi.org/10.1016/j.jamda.2014.04.021.CrossRefPubMed

27.

Morley JE, Vellas B, Abellan van Kan G, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013. https://doi.org/10.1016/j.jamda.2013.03.022.CrossRefPubMedPubMedCentral

28.

Bahrmann A, Bahrmann P, Baumann J, Bauer J, Brückel E, Dreyer M, et al. S2k-Leitlinie Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Alter: 2. Auflage 2018 – AWMF-Register-Nr. 057-017. Diabetol Stoffwechsel. 2018. https://doi.org/10.1055/a-0666-0820.CrossRef

29.

Pariser G, Hager K, Gillette P, Golemboski K, Jackson K. Active steps for diabetes: a community-campus partnership addressing frailty and diabetes. Diabetes Educ. 2014. https://doi.org/10.1177/0145721713514281.CrossRefPubMed

30.

Gordon PL, Vannier E, Hamada K, Layne J, Hurley BF, Roubenoff R, et al. Resistance training alters cytokine gene expression in skeletal muscle of adults with type 2 diabetes. Int J Immunopathol Pharmacol. 2006. https://doi.org/10.1177/039463200601900404.CrossRefPubMed

31.

Reusch JEB, Bridenstine M, Regensteiner JG. Type 2 diabetes mellitus and exercise impairment. Rev Endocr Metab Disord. 2013. https://doi.org/10.1007/s11154-012-9234-4.CrossRefPubMedPubMedCentral

32.

Bauer J, Biolo G, Cederholm T, Cesari M, Cruz-Jentoft AJ, Morley JE, et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the prot-age study group. J Am Med Dir Assoc. 2013. https://doi.org/10.1016/j.jamda.2013.05.021.CrossRefPubMedPubMedCentral

33.

Rawlings AM, Sharrett AR, Schneider ALC, Coresh J, Albert M, Couper D, et al. Diabetes in midlife and cognitive change over 20 years: a cohort study. Ann Intern Med. 2014. https://doi.org/10.7326/M14-0737.CrossRefPubMedPubMedCentral

34.

Li W, Huang E. An update on type 2 diabetes mellitus as a risk factor for dementia. J Alzheimers Dis. 2016. https://doi.org/10.3233/JAD-160114.CrossRefPubMedPubMedCentral

35.

Yaffe K, Falvey C, Hamilton N, Schwartz AV, Simonsick EM, Satterfield S, et al. Diabetes, glucose control, and 9‑year cognitive decline among older adults without dementia. Arch Neurol. 2012. https://doi.org/10.1001/archneurol.2012.1117.CrossRefPubMedPubMedCentral

36.

Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). J Am Med Assoc. 2003. https://doi.org/10.1001/jama.289.23.3095.CrossRef

37.

Katon W, Pedersen HS, Ribe AR, Fenger-Grøn M, Davydow D, Waldorff FB, Vestergaard M. Effect of depression and diabetes mellitus on the risk for dementia: a national population-based cohort study. JAMA Psychiatry. 2015;72(6):612–9.CrossRef

38.

van Dooren FEP, Nefs G, Schram MT, Verhey FRJ, Denollet J, Pouwer F. Depression and risk of mortality in people with diabetes mellitus: a systematic review and meta-analysis. PLoS ONE. 2013. https://doi.org/10.1371/journal.pone.0057058.CrossRefPubMedPubMedCentral

39.

Black SA, Markides KS, Ray LA. Depression predicts increased incidence of adverse health outcomes in older Mexican Americans with type 2 diabetes. Diabetes Care. 2003. https://doi.org/10.2337/diacare.26.10.2822.CrossRefPubMed

40.

Kimbro LB, Mangione CM, Steers WN, Duru OK, McEwen L, Karter A, et al. Depression and all-cause mortality in persons with diabetes mellitus: Are older adults at higher risk? Results from the translating research into action for diabetes study. J Am Geriatr Soc. 2014. https://doi.org/10.1111/jgs.12833.CrossRefPubMedPubMedCentral

41.

American Diabetes Association. 11. Older adults: standards of medical care in diabetes—2018. Diabetes Care. 2018;41(Supplement 1):S119–S25.CrossRef

42.

Huang ES, Liu JY, Moffet HH, John PM, Karter AJ. Glycemic control, complications, and death in older diabetic patients: the diabetes and aging study. Diabetes Care. 2011. https://doi.org/10.2337/dc10-2377.CrossRefPubMedPubMedCentral

43.

Gerstein HC, Miller ME, Byington RP, Goff DC, Bigger JT, Buse JB, et al. Effects of intensive glucose lowering in type 2 diabetes. (ACCORD study results). N Engl J Med. 2008. https://doi.org/10.1056/NEJMoa0802743.CrossRefPubMed

44.

Tan HH, McAlpine RR, James P, Thompson P, McMurdo MET, Morris AD, et al. Diagnosis of type 2 diabetes at an older age: effect on mortality in men and women. Diabetes Care. 2004. https://doi.org/10.2337/diacare.27.12.2797.CrossRefPubMed

45.

Landgraf R, Kellerer M, Fach E, Gallwitz B, Hamann A, Joost HG, et al. Praxisempfehlungen DDG/DGIM: Therapie des Typ-2-Diabetes. Diabetol Stoffwechsel. 2013. https://doi.org/10.1055/s-0033-1335297.CrossRef

46.

James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults. JAMA. 2014. https://doi.org/10.1001/jama.2013.284427.CrossRefPubMed

47.

Kirkman SM, Briscoe VJ, Clark N, Florez H, Haas LB, Halter JB, et al. Diabetes in older adults: a consensus report. J Am Geriatr Soc. 2012. https://doi.org/10.1111/jgs.12035.CrossRefPubMedPubMedCentral

48.

American Diabetes Association. Diabetes care: standards of medical care in diabetes—2018. Diabetes Care. 2018. https://doi.org/10.2337/dc18-S002.CrossRef

49.

Beckett NS, Peters R, Fletcher AE, Staessen JA, Liu L, Dumitrascu D, et al. (HyVET) treatment of hypertension in patients 80 years of age and older. N Engl J Med. 2008. https://doi.org/10.1056/NEJMoa0801369.CrossRefPubMed

50.

Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. 2018 ESC/ESH guidelines for themanagement of arterial hypertension. Eur Heart J. 2018. https://doi.org/10.1093/eurheartj/ehy339.CrossRefPubMedPubMedCentral

51.

Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, et al. 2016 ESC/EAS guidelines for the management of dyslipidaemias. Eur Heart J. 2016. https://doi.org/10.1093/eurheartj/ehw272.CrossRefPubMedPubMedCentral

52.

Abbatecola AM, Rizzo MR, Barbieri M, Grella R, Arciello A, Laieta MT, et al. Postprandial plasma glucose excursions and cognitive functioning in aged type 2 diabetics. Neurology. 2006. https://doi.org/10.1212/01.wnl.0000224760.22802.e8.CrossRefPubMed

53.

Bremer JP, Jauch-Chara K, Hallschmid M, Schmid S, Schultes B. Hypoglycemia unawareness in older compared with middle-aged patients with type 2 diabetes. Diabetes Care. 2009. https://doi.org/10.1212/01.wnl.0000224760.22802.e8.CrossRefPubMedPubMedCentral

54.

Whitmer RA, Karter AJ, Yaffe K, Quesenberry CP, Selby JV. Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus. JAMA. 2009. https://doi.org/10.1001/jama.2009.460.CrossRefPubMedPubMedCentral

55.

Punthakee Z, Miller ME, Launer LJ, Williamson JD, Lazar RM, Cukierman-Yaffee T, et al. Poor cognitive function and risk of severe hypoglycemia in type 2 diabetes: post hoc epidemiologic analysis of the ACCORD trial. Diabetes Care. 2012. https://doi.org/10.2337/dc11-1855.CrossRefPubMedPubMedCentral

56.

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr., et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report.[see comment][erratum appears in JAMA. 2003 Jul 9;290(2):197. JAMA. 2003. https://doi.org/10.1001/jama.289.19.2560.CrossRefPubMed

57.

SPRINT, Wright JT, Williamson JD, Whelton PSK, Snyder JK, Sink KM, Rocco MV, et al. BP targets in high-risk patients. N Engl J Med. 2015. https://doi.org/10.1056/NEJMoa1511939.CrossRef

58.

Schäfer HH, De Villiers JN, Sudano I, Dischinger S, Theus GR, Zilla P, et al. Recommendations for the treatment of hypertension in the elderly and very elderly—a scotoma within international guidelines. Swiss Med Wkly. 2012. https://doi.org/10.4414/smw.2012.13574.CrossRefPubMed

59.

Collins R, Armitage J, Parish S, Sleight P, Peto R. MRC/BHF heart protection study of cholesterol lowering with simvastatin in 20 536 high-risk individuals: a randomised placebo-controlled trial. Lancet. 2002. https://doi.org/10.1016/S0140-6736(02)09327-3.CrossRefPubMed

60.

Shepherd J, Blauw GJ, Murphy MB, Bollen ELEM, Buckley BM, Cobbe SM, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): a randomised controlled trial. Lancet. 2002. https://doi.org/10.1016/S0140-6736(02)11600-X.CrossRefPubMed

61.

Forman D, Wenger NK. What do the recent American Heart Association/American College of Cardiology Foundation clinical practice guidelines tell us about the evolving management of coronary heart disease in older adults? J Geriatr Cardiol. 2013. https://doi.org/10.3969/j.issn.1671-5411.2013.02.012.CrossRefPubMedPubMedCentral

62.

Donnan PT, MacDonald TM, Morris AD. Adherence to prescribed oral hypoglycaemic medication in a population of patients with type 2 diabetes: a retrospective cohort study. Diabet Med. 2002. https://doi.org/10.1046/j.1464-5491.2002.00689.x.CrossRefPubMed

63.

Lipska KJ, Bailey CJ, Inzucchi SE. Use of metformin in the setting of mild-to-moderate renal insufficiency. Diabetes Care. 2011. https://doi.org/10.2337/dc10-2361.CrossRefPubMedPubMedCentral

64.

Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, Nauck M, et al. Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centred approach. Diabetologia. 2015. https://doi.org/10.1007/s00125-014-3460-0.CrossRefPubMed

65.

Kos E, Liszek M, Emanuele M, Durazo-Arvizu R, Camacho P. Effect of Metformin therapy on vitamin D and vitamin B₁₂ levels in patients with type 2 diabetes mellitus. Endocr Pract. 2012. https://doi.org/10.4158/EP11009.OR.CrossRefPubMed

66.

De Jager J, Kooy A, Lehert P, Wulffelé MG, Van Der Kolk J, Bets D, et al. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B‑12 deficiency: randomised placebo controlled trial. BMJ. 2010. https://doi.org/10.1136/bmj.c2181.CrossRefPubMedPubMedCentral

67.

Ting RZW, Szeto CC, Chan MHM, Ma KK, Chow KM. Risk factors of vitamin B12 deficiency in patients receiving metformin. Arch Intern Med. 2006. https://doi.org/10.1001/archinte.166.18.1975.CrossRefPubMed

68.

Aroda VR, Edelstein SL, Goldberg RB, Knowler WC, Marcovina SM, Orchard TJ, et al. Long-term metformin use and vitamin B12 deficiency in the diabetes prevention program outcomes study. J Clin Endocrinol Metab. 2016. https://doi.org/10.1210/jc.2015-3754.CrossRefPubMedPubMedCentral

69.

Out M, Kooy A, Lehert P, Schalkwijk CA, Stehouwer CDA. Long-term treatment with metformin in type 2 diabetes and methylmalonic acid: post hoc analysis of a randomized controlled 4.3 year trial. J Diabetes Complicat. 2018. https://doi.org/10.1016/j.jdiacomp.2017.11.001.CrossRefPubMed

70.

Ferrannini E, Solini A. SGLT2 inhibition in diabetes mellitus: rationale and clinical prospects. Nat Rev Endocrinol. 2012. https://doi.org/10.1038/nrendo.2011.243.CrossRefPubMed

71.

Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, et al. EMPA-REG. N Engl J Med. 2015. https://doi.org/10.1056/NEJMoa1504720.CrossRefPubMed

72.

Monteiro P, Schaper N, Clark D, Hantel S, Woerle HJ, Inzucchi SE, et al. Effect of empagliflozin on heart failure outcomes in subgroups by age: results from EMPA-REG outcome. Diabetes Conf 76th Sci Sess Am diabetes Assoc ADA 2016. 2016.

73.

Monami M, Nardini C, Mannucci E. Efficacy and safety of sodium glucose co-transport-2 inhibitors in type 2 diabetes: a meta-analysis of randomized clinical trials. Diabetes Obes Metab. 2014. https://doi.org/10.1111/dom.12244.CrossRefPubMed

74.

Johnsson KM, Ptaszynska A, Schmitz B, Sugg J, Parikh SJ, List JF. Vulvovaginitis and balanitis in patients with diabetes treated with dapagliflozin. J Diabetes Complicat. 2013. https://doi.org/10.1016/j.jdiacomp.2013.04.012.CrossRefPubMed

75.

Johnsson KM, Ptaszynska A, Schmitz B, Sugg J, Parikh SJ, List JF. Urinary tract infections in patients with diabetes treated with dapagliflozin. J Diabetes Complicat. 2013. https://doi.org/10.1016/j.jdiacomp.2013.05.004.CrossRefPubMed

76.

Nyirjesy P, Sobel JD, Fung A, Mayer C, Capuano G, Ways K, et al. Genital mycotic infections with canagliflozin, a sodium glucose co-transporter 2 inhibitor, in patients with type 2 diabetes mellitus: a pooled analysis of clinical studies. Curr Med Res Opin. 2014. https://doi.org/10.1185/03007995.2014.890925.CrossRefPubMed

77.

Cefalu WT, Leiter LA, Yoon KH, Arias P, Niskanen L, Xie J, et al. Efficacy and safety of canagliflozin versus glimepiride in patients with type 2 diabetes inadequately controlled with metformin (CANTATA-SU): 52 week results from a randomised, double-blind, phase 3 non-inferiority trial. Lancet. 2013. https://doi.org/10.1016/S0140-6736(13)60683-2.CrossRefPubMed

78.

Schernthaner G, Gross JL, Rosenstock J, Guarisco M, Fu M, Yee J, et al. Canagliflozin compared with sitagliptin for patients with type 2 diabetes who do not have adequate glycemic control with metformin plus sulfonylurea: a 52-week randomized trial. Diabetes Care. 2013. https://doi.org/10.2337/dc12-2491.CrossRefPubMedPubMedCentral

79.

Vasilakou D, Karagiannis T, Athanasiadou E, Mainou M, Liakos A, Bekiari E, et al. Sodium-glucose cotransporter 2 inhibitors for type 2 diabetes: a systematic review and meta-analysis. Ann Intern Med. 2013. https://doi.org/10.7326/0003-4819-159-4-201308200-00007.CrossRefPubMed

80.

Drucker DJ, Nauck MA. The incretin system: glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors in type 2 diabetes. Lancet. 2006. https://doi.org/10.1016/S0140-6736(06)69705-5.CrossRefPubMed

81.

Dormandy JA, Charbonnel B, Eckland DJA, Erdmann E, Massi-Benedetti M, Moules IK, et al. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial. Lancet. 2005. https://doi.org/10.1016/S0140-6736(05)67528-9.CrossRefPubMed

82.

Stafford S, Elahi D, Meneilly GS. Effect of the dipeptidyl peptidase-4 inhibitor sitagliptin in older adults with type 2 diabetes mellitus. J Am Geriatr Soc. 2011. https://doi.org/10.1111/j.1532-5415.2011.03438.x.CrossRefPubMed

83.

Barzilai N, Guo H, Mahoney EM, Caporossi S, Golm GT, Langdon RB, et al. Efficacy and tolerability of sitagliptin monotherapy in elderly patients with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. Curr Med Res Opin. 2011. https://doi.org/10.1185/03007995.2011.568059.CrossRefPubMed

84.

Schwartz SL. Treatment of elderly patients with type 2 diabetes mellitus: a systematic review of the benefits and risks of dipeptidyl peptidase-4 inhibitors. Am J Geriatr Pharmacother. 2010. https://doi.org/10.1016/j.amjopharm.2010.10.003.CrossRefPubMed

85.

Pratley RE, McCall T, Fleck PR, Wilson CA, Mekki Q. Alogliptin use in elderly people: a pooled analysis from phase 2 and 3 studies. J Am Geriatr Soc. 2009. https://doi.org/10.1111/j.1532-5415.2009.02484.x.CrossRefPubMed

86.

Defronzo RA, Fleck PR, Wilson CA, Mekki Q. Efficacy and safety of the dipeptidyl peptidase-4 inhibitor alogliptin in patients with type 2 diabetes and inadequate glycemic control: a randomized, double-blind, placebo-controlled study. Diabetes Care. 2008. https://doi.org/10.2337/dc08-1035.CrossRefPubMedPubMedCentral

87.

Barnett AH. The role of GLP-1 mimetics and basal insulin analogues in type 2 diabetes mellitus: guidance from studies of liraglutide. Diabetes Obes Metab. 2012. https://doi.org/10.1111/j.1463-1326.2011.01523.x.CrossRefPubMedPubMedCentral

88.

Graefe-Mody U, Friedrich C, Port A, Ring A, Retlich S, Heise T, et al. Effect of renal impairment on the pharmacokinetics of the dipeptidyl peptidase-4 inhibitor linagliptin. Diabetes Obes Metab. 2011. https://doi.org/10.1111/j.1463-1326.2011.01458.x.CrossRefPubMed

89.

Van de Laar Floris A, Lucassen Peter LBJ, Akkermans Reinier P, Van de Lisdonk Eloy H, Rutten Guy EHM, Van Weel C. Alpha-glucosidase inhibitors for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005. https://doi.org/10.1002/14651858.CD003639.pub2.CrossRef

90.

Braun AK, Kubiak T, Kuntsche J, Meier-Höfig M, Müller UA, Feucht I, et al. SGS: a structured treatment and teaching programme for older patients with diabetes mellitus—a prospective randomised controlled multi-centre trial. Age Ageing. 2009. https://doi.org/10.1093/ageing/afp056.CrossRefPubMedPubMedCentral

91.

Sinclair A, Morley JE, Rodriguez-Mañas L, Paolisso G, Bayer T, Zeyfang A, et al. Diabetes mellitus in older people: position statement on behalf of the International Association of Gerontology and Geriatrics (IAGG), the European Diabetes Working Party for Older People (EDWPOP), and the International Task Force of Experts in Diabetes. J Am Med Dir Assoc. 2012. https://doi.org/10.1016/j.jamda.2012.04.012.CrossRefPubMed

92.

Davies MJ, D’Alessio DA, Fradkin J, Kernan WN, Mathieu C, Mingrone G, et al. Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2018. https://doi.org/10.2337/dci18-0033.CrossRefPubMedPubMedCentral

Titel: Geriatrische Aspekte bei Diabetes mellitus (Update 2019)
verfasst von: Joakim Huber
Michael Smeikal
Christoph H. Saely
Harald Stingl
Monika Lechleitner
Peter Fasching
Publikationsdatum: 12.04.2019
Verlag: Springer Vienna
Schlagwörter: Insuline
Insuline
Diabetes mellitus
Hypoglykämie
Erschienen in: Wiener klinische Wochenschrift / Ausgabe Sonderheft 1/2019
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI: https://doi.org/10.1007/s00508-019-1463-z

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Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

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Weitere Artikel der Sonderheft 1/2019

Diagnostik und Therapie des Typ 1 Diabetes mellitus (Update 2019)

Diabetische Neuropathie und diabetischer Fuß (Update 2019)

Diagnose, Therapie und Verlaufskontrolle der diabetischen Augenerkrankung (Update 2019)

Individualisierung der antihypertensiven Therapie bei Patienten mit Diabetes mellitus. Leitlinie der Österreichischen Diabetes Gesellschaft (Update 2019)

Zusammenfassung der Überarbeitungen 2019