Assisted living: improving glucose control for the functionally independent patient with diabetes.
OBJECTIVE
This clinical review guides consultant pharmacists on how best to integrate a range of parameters, such as glycosylated hemoglobin (A1C) levels, patient comorbidities, and quality of life issues specific to seniors, and drug risks and benefits, when determining optimal therapeutic decisions for elderly patients with type 2 diabetes mellitus (T2DM). It also discusses clinical use of incretin-based therapies that provide important new alternatives in improving glycemic levels, extend a positive effect on weight, and minimize hypoglycemic risk.


METHODS
Live symposium presentation based on clinical practice and research, medical literature, and studies published between April 1995 and January 2010 on managing diabetes in older adults, government statistics, and medical society guidelines.


CONCLUSIONS
Minimizing or delaying long-term complications, maximizing functional status, maintaining nutritional status, and initiating pharmacological therapy with established goals to control hyperglycemia and prevent hypoglycemia are important in the multifaceted management of older adults with diabetes.
Zettervall
Donald K
DK
The Diabetes Center, Old Saybrook, Connecticut, 06475, USA. diabctr@sbcglobal.net
D000368:Aged; D040561:Assisted Living Facilities; D001786:Blood Glucose / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D009752:Nutritional Status; D011788:Quality of Life; D012307:Risk Factors
D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents