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Diabetes Mellitus Bei Multimorbiden Patienten

Jürgen Wernecke
Published 2016 · Medicine

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ZusammenfassungHintergrundFür eine individualisierte Therapie und Diagnostik multimorbider, meist älterer und damit geriatrischer Patienten mit Diabetes mellitus ist eine Differenzierung in leicht- und hochgradig eingeschränkte bzw. behinderte sowie palliativ zu behandelnde Patienten hilfreich.DatenlageHintergrund für eine therapeutische und diagnostische Individualisierung sind die Ergebnisse von Langzeittherapiestudien mit protrahierten und lang anhaltenden Effekten einer Blutzuckerspiegeleinstellung sowie die neueren Daten zu den Gefahren schwerer Hypoglykämien.TherapierisikenMit den charakteristischen geriatrischen Syndromen lassen sich die Auswirkungen einer Multimorbidität u. a. auf Multimedikation und die Wechselwirkungen mit einem Diabetes mellitus sehr gut beschreiben. Die frühzeitige Erfassung und Beachtung dieser Defizite kann die Therapierisiken auch in Hinblick auf eine Polypharmazie minimieren helfen.AbstractBackgroundFor individualized therapy and diagnosis, differentiation of geriatric patients into mildly and highly disabled patients and palliative patients is helpful.DataThis differentiation is based on the results of long-term therapeutic trials including extended and long-acting effects of blood glucose control and newer data on the harm of severe hypoglycemia.Therapy risksClassification based on characteristic geriatric syndromes is useful to describe the effects of multimorbidity on polypharmacy and interactions with diabetes. Early detection of these deficits can also help minimize the therapeutic risks with respect to polypharmacy.
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