Document Detail


Management of the patient with advanced complications, functional decline, and persistent hyperglycemia.
MedLine Citation:
PMID:  20726377     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Current management of hypoglycemic risk among seniors with type 2 diabetes mellitus (T2DM) is frequently not very effective. Treatment guidelines with target glycosylated hemoglobin (A1C) levels provide important standards for T2DM management, but target goals must be determined on an individual basis in conjunction with individual factors, including risk of hypoglycemia. This clinical review will help pharmacists develop optimal therapeutic regimens for elderly diabetic patients that carefully balance risks and benefits of therapy, better assess their elderly patients' risk of hypoglycemia, and determine appropriate blood glucose testing schedules for the long-term care patient. DATA SOURCES: Live symposium presentation based on clinical practice and research, medical literature, and studies published between January 1998 and April 2009 on managing diabetes in older adults, government statistics, and medical society guidelines. CONCLUSIONS: When treating seniors with T2DM, it is critical that hypoglycemia be identified and avoided. Hypoglycemia, whether undiagnosed, recurring, or brought about with the use of traditional insulin or other antihyperglycemic agents with higher hypoglycemic risk, can lead to the risk of falls and injuries related to that. Certain therapeutic measures, including alterations to blood glucose testing schedules, less stringent A1C goals, and insulin analog therapies, facilitate effective glycemic control and decrease the risk of hypoglycemia.
Authors:
Donald K Zettervall
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Consultant pharmacist : the journal of the American Society of Consultant Pharmacists     Volume:  25 Suppl B     ISSN:  0888-5109     ISO Abbreviation:  Consult Pharm     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-09-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9013983     Medline TA:  Consult Pharm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5-10     Citation Subset:  IM    
Affiliation:
The Diabetes Center, in Old Saybrook, Connecticut 06475, USA. diabctr@sbcglobal.net
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Glucose / drug effects
Diabetes Mellitus, Type 2 / drug therapy*
Female
Hemoglobin A, Glycosylated / metabolism*
Humans
Hyperglycemia / drug therapy
Hypoglycemia / chemically induced,  diagnosis,  prevention & control*
Hypoglycemic Agents / adverse effects,  therapeutic use*
Pharmacists / organization & administration
Practice Guidelines as Topic
Risk Factors
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 0/Hypoglycemic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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