Diabetes Treatment Approaches and Blood Glucose Regulation in Elderly Patients - Retrospective Study

Yıl 2018, Cilt: 1 Sayı: 3, 96 - 103, 31.12.2018

Banu Büyükaydın Elmas Biberci Keskin

Öz

 

Objective: Diabetes mellitus is one of the most common disorders in the geriatric population. In these cases, it is difficult to regulate blood sugar and determine the clinical follow-up planing due to comorbidities, cognitive dysfunction and polypharmacy.

 In this study, we wanted to evaluate the diabetic regulation status and selected treatment modalities in diabetic geriatric patients.

 

Material and Methods: Seventy-five patients who met the inclusion criteria were included in the study. Fasting blood glucose, Hba1c levels and treatment modalities were recorded. The number of outpatient applications and related branches were also evaluated.

 

Results: The mean age of the patients was 71 ± 5 years. Mean fasting blood glucose and Hba1c levels were 133 ± 33 mg / dl and 6.98 ± 0.96, respectively. There was a positive correlation between fasting blood glucose levels and Hba1c levels and between LDL cholesterol and triglyceride levels (p <0.001). Vitamin B12 levels were found to be significantly lower in patients with high serum glucose (p = 0.005). 37 patients (49.3%) were under treatment with oral antidiabetics and 30 patients (40%) with oral antidiabetic and insulin. The number of hospital admissions was 1-15 times (4 ± 2). In the last 6 months along with diabetes polyclinic, most of the patients were admitted to ophthalmology.

 

Conclusion: In this study, we determined that the glucose regulation of the geriatric diabetic patients was acceptable. However, for the optimal treatment, follow-up methods for diabetes-related complications and standard scales like atherosclerosis risk scores are necessary.

Anahtar Kelimeler

Diabetes mellitus, elderly

Geriatrik Diabetes Mellitus Olgularında Kan Şekeri Regülasyon Durumu ve Tedavi Yaklaşımlarını İçeren Retrospektif Değerlendirme

Öz

Amaç: Diabetes mellitus, geriatrik popülasyonda sık
görülen kronik hastalıklardan birisidir. Bu olgularda eşlik eden
komorbiditeler, kognitif disfonksiyon ve polifarmasi nedeni ile kan şekerini
regüle etmek ve klinik takip planını belirlemek zor olmaktadır. Bu çalışmada
diyabetik geriatrik olguların kan şekeri regülasyonlarını ve kullanılan tedavi
yöntemlerini değerlendirmeyi amaçladık.

 

Gereç ve Yöntemler:
Diyabet polikliniğine
başvuran ve dahil edilme kriterlerini karşılayan 75 hasta çalışmaya alındı. Tüm
hastaların başvuru sırasındaki açlık kan şekeri, Hba1c düzeyleri ve kullanılan
tedavi yöntemleri kayıt edildi. Son 6 ay içerisinde başvuru yapılmış olan
poliklinik sayısı ve ilgili branşlar değerlendirildi. 

 

Bulgular: Hastaların yaş ortalaması 71 ± 5 yıldı.
Ortalama açlık kan şekeri ve Hba1c düzeyi sırası ile 133 ± 33 mg/dl, 6,98 ±
0,96 şeklindeydi. Açlık kan şekeri ile Hba1c düzeyleri arasında ve LDL
kolesterol ile trigliserid düzeyleri arasında pozitif yönde bir korelasyon
vardı (p<0,001). Serum glukozu yüksek olan hastalarda vitamin B12 düzeyi
istatistiksel olarak anlamlı daha düşük saptandı (p=0,005). 37 hasta (%49,3)
sadece oral antidiyabetik, 30 hasta (%40) ise oral antidiyabetik ve insülin
kombinasyonu kullanıyordu. Hastaneye başvuru sayısı 1-15 kez (4±2) şeklindeydi.
Diyabet polikliniğinden sonra son 6 ay içerisinde en sık göz hastalıkları
polikliniğine başvuru yapılmıştı.

 

Sonuç: Bu çalışma ile kliniğimizde takip edilen
geriatrik diyabetik olguların kan şeker regülasyonlarının kabul edilebilir
düzeyde olduğunu saptadık. Ancak bu olgularda optimal tedavi planı için
ateroskleroz risk faktörleri, diyabet ilişkili morbidite ve komplikasyonların
değerlendirildiği standart ölçek ve takip yöntemlerinin kullanılmasına ihtiyaç
vardır.

Anahtar Kelimeler

yaşlı, multidisipliner yaklaşım, diabetes mellitus

Kaynakça

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