Type 2 diabetes mellitus in elderly institutionalized patients.
A 93-year-old woman is admitted to a conventional hospital ward for an acute respiratory infection. The patient has type 2 diabetes mellitus of approximately 15 years evolution and has no other associated comorbidities, except for progressive dependence due to senescence and a previous hospitalization for pneumonia 6 months ago. She is currently in an assisted-living residence. A recent laboratory test revealed an HbA1c level of 7.8%, with a serum creatinine level of 1.3mg/dl (MDRD, 45ml/min). Her standard treatment consists of 5mg of glibenclamide a day and 850mg of metformin every 12hours. What regimen should we follow once she is hospitalized? Does she require any change in her treatment at discharge?
Servicio de Nefrología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, España. Electronic address: mcanomegias@gmail.com.
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Cano Megias
Servicio de Medicina Interna, Hospital Quirón San Camilo, Madrid, España. Electronic address: pablogvasco@gmail.com.
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Guisado Vasco
Ancianos; Diabetes mellitus tipo 2; Home nursing care; Institucionalizados; Older people