College of Pharmacy and Pharmaceutical Sciences, Washington State University, 412 East Spokane Falls Boulevard, Spokane, WA 99210, USA.
Geriatric Diabetes Program, Joslin Diabetes Centre, Harvard Medical School, 1 Brookline Place, Suite 230, Brookline, MA 02445, USA.
Endocrinol Metab Clin North Am. 2023 Jun;52(2):341-353. doi: 10.1016/j.ecl.2022.10.004. Epub 2023 Feb 19.
Over one-quarter of adults ≥65 years old have diabetes in the United States. Guidelines recommend individualization of glycemic targets in older adults with diabetes as well as implementing treatment strategies that minimize risk for hypoglycemia. Patient-centered management decisions should be informed by comorbidities, the individual's capacity for self-care, and the presence of key geriatric syndromes that may impact self-management and patient safety. Key geriatric syndromes include cognitive impairment, depression, functional impairments (eg, vision, hearing, and mobility challenges), falls and fractures, polypharmacy, and urinary incontinence. Screening for geriatric syndromes in older adults is recommended to inform treatment strategies and optimize outcomes.
超过四分之一的美国 65 岁及以上成年人患有糖尿病。指南建议对老年糖尿病患者进行个体化血糖目标，并采取能够最大程度降低低血糖风险的治疗策略。以患者为中心的管理决策应考虑合并症、个体自我护理能力以及可能影响自我管理和患者安全的主要老年综合征。主要老年综合征包括认知障碍、抑郁、功能障碍（如视力、听力和移动能力障碍）、跌倒和骨折、多种药物治疗以及尿失禁。建议对老年人进行老年综合征筛查，以指导治疗策略并优化治疗结果。
