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

Anke Bahrmann; Philipp Bahrmann; Jeannette Baumann; Jürgen Bauer; Elke Brückel; Manfred Dreyer; Michael Freitag; Alexander Friedl; Stefan Gölz; Susanne Grundke; Sonja Hiddemann; Katja Hodeck; Werner Kern; Ulrich Kintscher; Thomas Kubiak; Bernhard Kulzer; Young Hee Lee-Barkey; Ralf Lobmann; Nikolaus Marx; Frank Schröder; Astrid Tombek; Til Uebel; Jürgen Wernecke; Andrej Zeyfang

doi:10.1055/a-0666-0820

Diabetologie und Stoffwechsel, Table of Contents

Diabetologie und Stoffwechsel 2018; 13(05): 423-489
DOI: 10.1055/a-0666-0820

Leitlinie

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

2. Auflage 2018 – AWMF-Register-Nr. 057-017

Authors

Anke Bahrmann

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Philipp Bahrmann

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Jeannette Baumann

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Jürgen Bauer

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Elke Brückel

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Manfred Dreyer

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Michael Freitag

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Alexander Friedl

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Stefan Gölz

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Susanne Grundke

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Sonja Hiddemann

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Katja Hodeck

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Werner Kern

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Ulrich Kintscher

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Thomas Kubiak

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Bernhard Kulzer

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Young Hee Lee-Barkey

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Ralf Lobmann

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Nikolaus Marx

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Frank Schröder

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Astrid Tombek

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Til Uebel

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Jürgen Wernecke

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern
Andrej Zeyfang

medius KLINIK OSTFILDERN-RUIT, Klinik für Innere Medizin, Altersmedizin und Palliativmedizin, Ostfildern

Abstract

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

Full Text

References

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