Zeyfang Andrej, Zeeh Joachim, Bahrmann Anke, Kugler Janine N, Heppner Hans Jürgen
Klinik für Innere Medizin, Altersmedizin, Diabetologie und Palliativmedizin, medius KLINIK OSTFILDERN-RUIT, Hedelfinger Str. 166, 73760, Ostfildern, Deutschland.
Institut für Epidemiologie, Universität Ulm, Albert-Einstein-Allee 41, 89081, Ulm, Deutschland.
Z Gerontol Geriatr. 2021 Feb;54(1):61-71. doi: 10.1007/s00391-020-01815-1. Epub 2020 Nov 26.
In the treatment of diabetes in old age cognitive, functional and constitutional resources of the individual must be taken into account. Purely glycated hemoglobin (HbA1c)-oriented treatment goals are less relevant. The primary focus should be freedom from symptoms while avoiding hypoglycemia and maintaining the quality of life. The geriatric assessment helps to clarify the current functional, psychological and cognitive status as well as the need for support in multimorbid older people and to define appropriate treatment strategies. With drug treatment of diabetes in old age, particular attention must be paid to renal insufficiency and dehydration as well as slow dose adjustments. According to the Robert Koch Institute (RKI), diabetes patients belong to the risk group for a severe course of the coronavirus disease 2019 (COVID-19); further risk factors are high blood pressure, underlying oncological diseases, cerebrovascular and coronary heart diseases.
在老年糖尿病治疗中，必须考虑个体的认知、功能和体质状况。单纯以糖化血红蛋白（HbA1c）为导向的治疗目标相关性较低。主要重点应是无糖尿病症状，同时避免低血糖并维持生活质量。老年综合评估有助于明确多病共存的老年人当前的功能、心理和认知状况以及支持需求，并确定合适的治疗策略。在老年糖尿病药物治疗中，必须特别注意肾功能不全、脱水以及缓慢的剂量调整。根据德国罗伯特·科赫研究所（RKI）的数据，糖尿病患者属于2019冠状病毒病（COVID-19）重症病程的风险群体；其他风险因素包括高血压、潜在肿瘤疾病、脑血管疾病和冠心病。
