Diabetes Mellitus at an Elderly Age.

Abstract

recommendation 1: Modification of the use of GLP-1 agonists and SGLT-2 inhibitors in the elderly reason: NVL Type 2 DM supporting reference: REWIND, LEADER, SUSTAIN-6, EXSCEL, ELIXA, EMPE-REG, DAPA-HF recommendation 2: Participatory decision-making, individualized therapy reason: NVL Type 2 DM supporting reference: [5] recommendation 3: HbA1c target corridor reason: NVL Type 2 DM supporting reference: [5] recommendation 4: References Due to the good medical care in Germany, many people with diabetes mellitus now reach old age: Of the 340,000 adults with type 1 diabetes, more than 100,000 are over 70 years of age. Approximately 8 million people have type 2 diabetes and one-fourth of this group is over 75 years of age, and approximately 1 million over the age of 80 [1]. Nationwide, there are a total of about 630,000 people with diabetes mellitus in need of care. The statements in the practice recommendations are mainly directed at the majority of elderly people with type 2 diabetes and can only reflect some of the special characteristics of elderly people with diabetes. Topics such as type 1 diabetes at an elderly age, end of life, interface management or ethics are covered in the complete S2k guideline. The geriatric patient is defined by multimorbidity and a higher age. Age-typical functional limitations and high vulnerability create a special need for action that goes beyond blood glucose control and the management of cardiovascular risk factors or diabetes-typical complications. For differentiated therapy planning, elderly patients should be divided into functional groups (▶tab. 1). A geriatric assessment should be conducted to determine resources and deficits (division into functional groups) (Practice Tool 1, see Appendix).