Геронтология и гериатрические исследования

Абстрактный

ANASTE Calabria Recommendations for the Treatment of Frail Elderly Diabetic Patients Hospitalized in Nursing Homes

Giovanni Sgro, Alba Malara, Grazia Francesca Renda, Giuseppe Curinga, Fausto Spadea, Vincenzo Rispoli, Francesco Ceravolo and Michele Garo

The prevalence of diabetes increases with age became higher in elderly and in patients admitted to nursing home. During aging, a functional reduction of the beta cell and increase in insulin resistance causes a greater risk in developing diabetes mellitus. It is also well known that association between aging and insulin resistance, recognizes a multifactorial origin. In elderly, both reduced physical activity and increase of visceral adipose tissue may play a causal role that it at least partly follows. Older adults with diabetes have higher rates of functional disability and sudden death, and concomitant diseases such as hypertension, coronary heart disease and stroke than those without diabetes. Older adults with diabetes are at increased risk for several common geriatric syndromes, such as polypharmacy and adverse reaction to drugs, depression, cognitive impairment, urinary incontinence, and persistent pain. In particular, the risk of macrovascular events is doubled and it is related to the duration of illness, the metabolic compensation and the number of other cardiovascular risk factors already present. Most of the elderly subjects in Long-term care (LTC) facilities are frail. The treatment of the elderly with diabetes is complicated by the heterogeneity of functional and clinical status. Life expectancy and the clinical conditions are highly variable. In these patients who take care of elderly people with diabetes must take this heterogeneity of account when establishing the priorities and goals of treatment