The high prevalence of malnutrition in elderly diabetic patients: implications for anti-diabetic drug treatments

Diabetic Medicine : a Journal of the British Diabetic Association
U M VischerFrançois R Herrmann

Abstract

Type 2 diabetes usually occurs in the context of obesity and associated insulin resistance. Current treatment recommendations are based on lifestyle modifications and incremental drug therapy. However, this approach could lead to inappropriate priorities upon ageing, when diabetes may be compounded by malnutrition and reduced insulin resistance. We prospectively evaluated glycaemic and nutritional parameters in 146 consecutive diabetic patients (age 82.5 +/- 7.3 years, mean +/- sd) admitted to our geriatric service. We also implemented nutritional support therapy and a drug therapy adjustment protocol. Oral hypoglycaemic agent withdrawal was attempted in cases of good glycaemic control (HbA(1c) < 7.5% (<47 mmol/mol) or fasting blood glucose < 7.5 mmol/l). Mean BMI and HbA(1c) were 29.6 +/- 7.1 kg/m(2) and 6.9 +/- 1.2% (52 +/- 9 mmol/mol), respectively. Of the patients, 51.4% were taking 1-3 oral hypoglycaemic agents, 30.8% were on insulin and 9.6% on were on insulin and oral hypoglycaemic therapy. Low Mini Nutritional Assessment scores and serum marker levels indicated a high prevalence of malnutrition and/or chronic disease, even in obese patients. Mini Nutritional Assessment scores were positively associated with HbA(1c) valu...Continue Reading

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Citations

Apr 14, 2012·The Journal of Nutrition, Health & Aging·A FerraJ A Tur
Jan 20, 2011·Journal of the American Medical Directors Association·Ulrich M Vischer
Apr 16, 2011·Journal of the American Geriatrics Society·Caroline GerstelUlrich M Vischer
Oct 27, 2015·PeerJ·Tranquilina Gutiérrez-GómezRosa María Ferrer-Diego
Nov 6, 2012·British Journal of Community Nursing·Siobhan Hughes
Nov 1, 2011·Current Opinion in Clinical Nutrition and Metabolic Care·Emanuele Cereda
Oct 23, 2013·Hospital Practice·Isabelle Bourdel-Marchasson, Alan Sinclair
Nov 2, 2013·British Journal of Community Nursing·Alison Burton-Shepherd
Sep 25, 2020·Diabetic Medicine : a Journal of the British Diabetic Association·M P OktoraP Denig
May 1, 2018·British Journal of Community Nursing·Jane McClinchy
Mar 30, 2019·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Ilker TasciMehmet Ilkin Naharci

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