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Management of Type 2 Diabetes Mellitus in Older Adults
Kyung Soo Kim, Soo Kyung Kim, Kyung Mi Sung, Yong Wook Cho, Seok Won Park
Diabetes Metab J. 2012;36(5):336-344.   Published online October 18, 2012
DOI: https://doi.org/10.4093/dmj.2012.36.5.336
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AbstractAbstract PDFPubReader   

In the near future, the majority of patients with diabetes will be adults aged 65 or older. Unlike young adults with diabetes, elderly diabetic people may be affected by a variety of comorbid conditions such as depression, cognitive impairment, muscle weakness (sarcopenia), falls and fractures, and physical frailty. These geriatric syndromes should be considered in the establishment of treatment goals in older adults with diabetes. Although there are several guidelines for the management of diabetes, only a few are specifically designed for the elderly with diabetes. In this review, we present specific conditions of elderly diabetes which should be taken into account in the management of diabetes in older adults. We also present advantages and disadvantages of various glucose-lowering agents that should be considered when choosing a proper regimen for older adults with diabetes.

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Original Article
The Correlation between Central Obesity and Glucose, Lipid Metabolism and Macrovascular Complication in Elderly Type 2 Diabetes.
Eui Dal Jung, Jihyun Lee, Ho Sang Shon
Korean Diabetes J. 2007;31(4):343-350.   Published online July 1, 2007
DOI: https://doi.org/10.4093/jkda.2007.31.4.343
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  • 23 Download
  • 2 Crossref
AbstractAbstract PDF
BACKGROUND
Obesity is related to abnormal lipid metabolism and macrovascular complication and accumulated fat on the abdomen in elderly diabetic patients. The aim of this study was to compare elderly diabetic patients' body fat composition with middle-aged patients and evaluate the role of central obesity on glucose and lipid metabolism and macrovascular complications in elderly type 2 diabetic patients. METHODS: We defined elderly patients who are over 65 years old and who waist circumference is over than 90 cm in men and 85 cm in women and waist-hip ratio (WHR) was over than 0.90 in men and 0.85 in women defined central obesity. % body fat were measured a bioimpedence analysis using DSM (Direct Segmental Measurement by 8-point electrode) method (Inbody 3.0, Biospace, Seoul, Korea) in two hundred two type 2 diabetes. Laboratory parameters such as fasting blood glucose, HbA1c, and lipid profile were included in this study and also investigated the macrovascular complication. RESULTS: 1) The ninety-five elderly diabetic patients, compared with middle-aged diabetic patients, were similar BMI and % of body fat but significantly increased waist circumference (P < 0.05) and WHR (P < 0.001). 2) In pearson's correlations, waist circumference was correlated with BMI (r = 0.927, P < 0.001), WHR (r = 0.851, P < 0.001), % body fat (r = 0.519, P < 0.001), total cholesterol (r = 0.255, P < 0.05), triglyceride (r = 0.365, P < 0.001), and LDL-cholesterol (r = 0.271, P < 0.05) in elderly diabetic patients. And WHR was also correlated with BMI (r = 0.744, P < 0.001), waist circumference (r = 0.851, P < 0.001), % body fat (r = 0.425, P < 0.001), total cholesterol (r = 0.372, P < 0.001), triglyceride (r = 0.408, P < 0.001), and LDL-cholesterol (r = 0.386, P < 0.001). 3) The obese elderly diabetic patients had increased triglyceride, total cholesterol and LDL-cholesterol but not related with macrovascular complication compared with lean elderly patients. CONCLUSION: In elderly type 2 diabetic patients are more central obesity although the same weight compared with middle-aged patients. Waist circumference and WHR were highly correlated with body fat composition and lipid profile in elderly diabetes. In obese elderly patients have abnormal lipid profile but not more macrovascular complication.

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