Diabetes Metab J.  2017 Jun;41(3):155-159. 10.4093/dmj.2017.41.3.155.

Comprehensive Approach for Managing the Older Person with Diabetes Mellitus

Affiliations
  • 1Division of Endocrinology Metabolism and Geriatric Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea. hjoonyoo@gmail.com

Abstract

Care of the elderly population with diabetes may not be restricted to the management of hyperglycemia, associated risk factors, and specific diabetic complications. An integrated approach should also include the assessment and management of gerontological problems. Both diabetes mellitus and aging interact toward the direction of the increased incidence of geriatric syndromes. Education is a common element of both diabetes control and geriatric syndrome care. However, it has been perceived that conventional education programs for diabetics are not as effective for the elderly. We have designed geriatric reinforced education (GRE) for application in older diabetics with geriatric syndromes. We observed that the application of GRE improved the glucose control and the status of geriatric syndromes in older adults with diabetes. In summary, in terms of integrating the care of coexisting diabetes and geriatric problems, GRE may be a beneficial tool for the management of older adults with diabetes.

Keyword

Diabetes mellitus; Education; Geriatric assessment

MeSH Terms

Adult
Aged
Aging
Diabetes Complications
Diabetes Mellitus*
Education
Geriatric Assessment
Glucose
Humans
Hyperglycemia
Incidence
Risk Factors
Glucose

Figure

  • Fig. 1 Fields of gerontology.

  • Fig. 2 Inhibitory effects of rutin on glucose fluctuation-induced vascular smooth muscle cell migration in Otsuka Long-Evans Tokushima fatty rats. The inhibitory effect of rutin on BMK1 (migration pathway) was by Western blot analysis. Five separate experiments were performed. P-BMK1, phosphory-lated-big mitogen-activated protein kinase 1; C, control; F, glucose fluctuation; R, rutin. aP<0.05 vs. control, bP<0.001 vs. glucose fluctuations.

  • Fig. 3 Health literacy in older persons with diabetes mellitus (n=84).

  • Fig. 4 Diabetes mellitus (DM) and aging interact toward the direction of the increased incidence of the geriatric syndromes.

  • Fig. 5 Education effects on (A) disability and (B) malnutrition after 6 months' education. Conventional diabetes education (CE, n=30), geriatric reinforced education (GRE, n=30). When the activities of daily living score is <7, the functional status is considered as disabled. When the mini nutritional assessment is ≥24, the nutritional status is considered good.


Cited by  1 articles

Treatment Goals for Glycemia in Older Patients with Diabetes Mellitus
Jung Ah Lim
J Korean Diabetes. 2019;20(4):220-224.    doi: 10.4093/jkd.2019.20.4.220.


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