The treatment strategy for type 2 diabetes in old age patients should prevent and minimize the risk of developing hypoglycemic conditions. Elderly patients with type 2 diabetes are at high risk of developing hypoglycemia, which threatens their lives. Myocardial infarction, severe arrhythmia, cerebral stroke, coma, and other dangerous consequences can develop due to inappropriate treatment (Binz et al., 2012). Another aspect of the problem is that due to the numerous concomitant diseases, the effects of chronic hyperglycemia are steadily increasing (Addante et al., 2014). Vascular complications of diabetes may progress, and the risk of mortality from cardiovascular diseases increases.
Many elderly patients have vascular and neurological complications even without diabetes. Thus, when this illness is diagnosed, they are at increased risk of aggravation of these problems. In clinical practice, elderly patients usually are prescribed antihyperglycemic drugs, while usually to normalize glycemia, it is enough to change the nutrition and increase physical activity (Bullo et al., 2013). In the process of treating type 2 diabetes mellitus, elderly patients are advised to monitor both the blood sugar and cholesterol, triglycerides, and blood pressure (Deary et al., 2011). These coefficients should be kept within the established norms to avoid the disease’s aggravation (Choue et al., 2010). If the indicators deviate from the established norms, adjustments are made to the treatment program: diet, drugs of the statin group, antihypertensive drugs (Bullo et al., 2012). Thus, the drug treatment of elderly patients with diabetes is advised only when the non-drug therapies, dieting, and physical activities show no positive results.
PICOT
In elderly patients with diabetes type II (P), are the non-drug treatment practices (diet and exercise) (I) more valuable than the antihyperglycemic drugs (O) in minimizing the risk of developing hypoglycemia in long time perspective (T)?
References
Addante, F., Cavallo, P., Crepaldi, G., naggi, S., Nale, M., Pilotto, A., & Tiengo, A. (2014). Hypoglycemia is independently associated with multidimensional impairment in elderly diabetic patients. BioMed Research International, 2014, 1–7. Web.
Binz, C., Bramlage, P., Deeg., E., Gitt, A., & Krekler, M. (2012). Oral antidiabetic treatment in type-2 diabetes in the elderly: balancing the need for glucose control and the risk of hypoglycemia. Cardiovasc Diabetol, 11(122), 1–9. Web.
Bullo, M., Casas, R., Estruch, R., Juanola-Falgarona, M., Martinez-Gonzales, M., Miranda, J., Portillo, M., & Salas-Salvado, J. (2013). Association between dietary phylloquinone intake and peripheral metabolic risk markers related to insulin resistance and diabetes in elderly subjects at high cardiovascular risk. Cardiovascular Diabetology, 12(7), 1–9. Web.
Bullo, M., Ibarrola-Jurando, N., Martinez-Gonzales, M., & Salas-Salvado, J. (2012). Dietary phylloquinone intake and risk of type 2 diabetes in elderly subjects at high risk of cardiovascular disease. The American Journal of Clinical Nutrition, 96(5), 1113–1118. Web.
Choue, R., Park, S., Woo, J., & Woo, M. (2010). A comparative study of diet in good and poor glycemic control groups in elderly patients with type 2 diabetes mellitus. The American Korean Diabetes Journal, 34(5), 303–311. Web.
Deary, I., Frier, B., Gibson, G., Stereftaris, G., & Zammitt, N. (2011). Modeling the consistency of hypoglycemic symptoms: High variability in diabetes. Diabetes Technology & Therapeutics, 13(5), 571–578. Web.