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Vol. 214. Issue 9.
Pages 521-528 (December 2014)
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Vol. 214. Issue 9.
Pages 521-528 (December 2014)
Clinical up-date
Type 2 diabetes mellitus in elderly institutionalized patients
Diabetes mellitus tipo 2 en el paciente anciano institucionalizado
Visits
908
M. Cano Megiasa,
Corresponding author
mcanomegias@gmail.com

Corresponding author.
, P. Guisado Vascob
a Servicio de Nefrología, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
b Servicio de Medicina Interna, Hospital Quirón San Camilo, Madrid, Spain
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Tables (4)
Table 1. Diabetes treatment objectives for elderly institutionalized patients.
Table 2. General recommendations for the treatment of diabetes in elderly institutionalized patients.
Table 3. Summary of the main characteristics of hypoglycemic agents used in frail elderly patients.
Table 4. Important clinical aspects to consider when treating elderly institutionalized patients.
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Abstract

A 93-year-old woman is admitted to a conventional hospital ward for an acute respiratory infection. The patient has type 2 diabetes mellitus of approximately 15 years evolution and has no other associated comorbidities, except for progressive dependence due to senescence and a previous hospitalization for pneumonia 6 months ago. She is currently in an assisted-living residence. A recent laboratory test revealed an HbA1c level of 7.8%, with a serum creatinine level of 1.3mg/dl (MDRD, 45ml/min). Her standard treatment consists of 5mg of glibenclamide a day and 850mg of metformin every 12h. What regimen should we follow once she is hospitalized? Does she require any change in her treatment at discharge?

Keywords:
Diabetes mellitus tipo 2
Older people
Home nursing care
Resumen

Una mujer de 93 años de edad ingresa en una planta de hospitalización convencional por una infección respiratoria aguda. La paciente tiene diabetes mellitus tipo 2 de unos 15 años de evolución y no presenta otras comorbilidades asociadas, salvo progresiva dependencia por senescencia y un ingreso hospitalario previo por neumonía hace 6 meses; actualmente vive en una residencia asistida. En un análisis reciente tenía una HbA1c de 7,8%, con una creatinina sérica de 1,3mg/dl (MDRD: 45ml/min). Su tratamiento habitual consistía en glibenclamida 5mg al día y metformina 850mg cada 12h. ¿Qué pauta debemos seguir una vez hospitalizada? ¿Precisa de alguna modificación de su tratamiento al alta?

Palabras clave:
Diabetes mellitus tipo 2
Ancianos
Institucionalizados

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