S2k-Leitlinie Diagnostik, Therapie und Verlaufskontrolle des Diabetes mellitus im Alter

Zusammenfassung

Die Diabetesprävalenz liegt in der Altersgruppe ab 80 Jahren bei über 30 %. Bei der Diagnostik und Therapie älterer Menschen mit Typ-1- und Typ-2 Diabetes müssen altersspezifische Besonderheiten wie funktionelle und kognitive Einschränkungen sowie Komorbiditäten und Aspekte der Polypharmazie in besonderem Maße berücksichtigt werden. Die S2k-Leitlinie der Deutschen Diabetes Gesellschaft wurde mit 6 weiteren Fachgesellschaften (Deutsche Gesellschaft für Kardiologie, Deutsche Gesellschaft für Allgemeinmedizin und Familienmedizin, Deutsche Gesellschaft für Geriatrie, Deutsche Gesellschaft für Ernährungsmedizin, Deutsche Gesellschaft für Pflegewissenschaft, Deutsche Gesellschaft für Palliativmedizin) und der Patientenvertretung (DBW) erarbeitet. Therapieziele wie Erhalt der Lebensqualität und strikte Vermeidung von Akutkomplikationen wie schwere Hypoglykämien treten in den Vordergrund. HbA1c-Ziele sollten gemeinsam mit den Patienten in Abhängigkeit der individuellen Wünsche und Fähigkeiten festgelegt werden. Altersspezifische Besonderheiten einzelner Medikamente müssen insbesondere im Kontext der Multimorbidität beachtet werden. In der Leitlinie werden pflegerische Aspekte, Schnittstellenmanagement, Schmerztherapie sowie häufige Komorbiditäten bei Diabetes wie Hypertonie, Frailty, Sarkopenie, Demenz, Depression, End-of-Life Situationen ausführlich dargestellt.

Abstract

Diabetes prevalence is over 30 % in the age group 80 years and older. In diagnostic and treatment of older people with type-1 and type-2 diabetes, age-specific features such as functional and cognitive deficits as well as comorbidities and aspects of polypharmacy must be taken into account. The S2k-guideline of the German Diabetes Association was developed together with six other medical societies (German Cardiac Society, German College of General Practitioners and Family Physicians, German Society for Geriatrics, German Society for Nutritional Medicine, German Society for Nursing Science, German Association for Palliative Medicine) and Patient Representation [DBW]): Main therapeutic goals in elderly diabetes patients are maintenance of quality of life and strict avoidance of acute complications (e.g. severe hypoglycemia). HbA1c goals consider both patients` preference and abilities. Age-specific features of diabetes medications must be taken into account, especially in the context of multimorbidity. The guideline describes in detail nursing aspects, interface management, pain therapy as well as frequent comorbidities in diabetes such as hypertension, frailty, sarcopenia, dementia, depression, end-of-life situations.

Schlüsselwörter

Leitlinie - Diabetes im Alter - Geriatrie - ältere Patienten - funktionelle Einschränkungen

Key words

guideline - diabetes in old age - geriatrics - older patients - functional limitations

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