Giraldo Gonzalez German C, González Robledo Luz M, Jaimes Montaña Isabel C, Benjumea Salgado Angela M, Pico Fonseca Sayda M, Arismendi Solano Martha J, Valencia Rico Claudia L
Doctorado en Ciencias de la Salud, Facultad de Ciencias de la Salud, Universidad de Caldas, Manizales 170004, Colombia.
Facultad de Medicina, Universidad Autónoma del Estado de Morelos, Cuernavaca 62350, Mexico.
J Cardiovasc Dev Dis. 2024 Sep 18;11(9):289. doi: 10.3390/jcdd11090289.
In the elderly, the coexistence of type 2 diabetes mellitus (T2DM) and frailty is frequent. Much has been described about pharmacological management and glycemic control goals. However, there is a knowledge gap in terms of the objectives and characteristics of interventions, especially nutritional ones, for this population. A scoping review was performed to document the objectives, characteristics, and results of nutritional interventions in older people with T2DM and frailty. The five-stage framework of Arksey and O'Malley was used, as was the PRISMA extension for scoping reviews. The results stand out for three trends, as follows: (1) experimental studies with multicomponent intervention physical exercise programs and nutritional programs based on educational processes or behavioral intervention; (2) observational studies with an association of the kind of diet assessed by scales and their relation to stages of frailty; (3) a review that updates recommendations on pharmacological and non-pharmacological, diet, exercise, management, as well as glucose control goals for diabetes in frail older persons. Finally, the evidence shows that management of T2DM in older adults with frailty requires goals and interventions tailored to their functional capacity and health condition. The exercise, diet, and education programs reviewed have demonstrated their effectiveness in improving physical performance, reducing the risk of frailty or progression to more advanced stages, and achieving better glycemic control.
在老年人中，2型糖尿病（T2DM）与虚弱并存的情况很常见。关于药物治疗管理和血糖控制目标已有很多描述。然而，对于这一人群的干预目标和特点，尤其是营养干预方面，存在知识空白。进行了一项范围综述，以记录对患有T2DM和虚弱的老年人进行营养干预的目标、特点和结果。采用了阿克西和奥马利的五阶段框架以及范围综述的PRISMA扩展。结果呈现出三个趋势，如下：（1）基于教育过程或行为干预的多成分干预体育锻炼计划和营养计划的实验研究；（2）通过量表评估饮食种类及其与虚弱阶段关系的观察性研究；（3）一项更新针对体弱老年人糖尿病的药物和非药物、饮食、运动、管理以及血糖控制目标建议的综述。最后，证据表明，对体弱的老年人进行T2DM管理需要根据其功能能力和健康状况制定目标和干预措施。所综述的运动、饮食和教育计划已证明在改善身体表现、降低虚弱风险或进展到更严重阶段以及实现更好的血糖控制方面具有有效性。
