To treat diabetes in the elderly, pay attention to these 12 things!

Compared with young diabetic patients, elderly diabetic patients have relatively insidious symptoms, poor liver and kidney function, are prone to hypoglycemia, have more complications or comorbidities, and have more prominent psychological problems... Therefore, elderly diabetic patients need to consider more issues.

1. Diet control should be moderate

Since the elderly have less activity and less energy consumption, they should be advised to properly control their diet; they should avoid eating high-fat foods such as fatty meat and meat oil, eat more whole grains, beans and fresh vegetables, increase their fiber intake, and avoid smoking. liquor.

When blood sugar is well controlled, you can eat a small amount of fruits with low sugar content (apples, pears), etc.; elderly patients with severe complications do not need to restrict their diet too much.

2. Physical exercise should be done according to one’s ability.

Unlike young people, the elderly must have a comprehensive physical examination before exercising.

If your cardiopulmonary function is good, you can choose brisk walking, jogging, cycling, Tai Chi and other sports; if you have severe myocardial ischemia or unstable angina, you should not exercise temporarily. In addition, exercise must be done step by step, within your ability, and persevere.

3. Select hypoglycemic drugs with caution

The elderly often have varying degrees of renal function decline and are prone to hypoglycemia. Therefore, they should try to choose antidiabetic drugs that do not rely on renal excretion and have a mild hypoglycemic effect; repaglinide and glaqidone mainly pass through the biliary tract. Excretion, acarbose is not absorbed by the intestines, these drugs are more suitable for the elderly, especially those with mild renal insufficiency. Try to avoid using strong, long-acting hypoglycemic drugs, such as glyburide, etc., to avoid hypoglycemia.

4. Liver function and kidney function need to be checked before taking medicine.

Antidiabetic drugs are generally metabolized in the liver and excreted by the kidneys. However, the liver and kidney functions of the elderly gradually decline with age. Some elderly people have a history of chronic liver disease and nephritis; therefore, they should be checked before taking the medicine. Liver and kidney function, when liver and kidney function is poor, drugs should be selected carefully. Otherwise, improper medication will further increase the burden on the liver and kidneys, leading to further deterioration of liver and kidney functions.

5. Improve medication compliance

The elderly have poor memory and often forget to take medicine, take the wrong medicine, or take heavy medicines, especially when there are too many types of medicines. Therefore, when formulating a treatment plan for elderly patients, the types and frequency of medication should be reduced to increase the patient's compliance with medication. DPP-4 inhibitors that only need to be taken once a day and have blood glucose-dependent hypoglycemic effects are a good choice.

6. Be careful about the interaction between drugs

Many elderly people with diabetes suffer from multiple diseases at the same time. In addition to anti-diabetic drugs, they also need to take a variety of other drugs. Among these drugs, some drugs (such as glucocorticoids, diuretics, estrogens, etc.) will weaken the anti-diabetic drugs. effect; some drugs (such as aspirin, propranolol, ACEI, etc.) can enhance the effect of hypoglycemic drugs. When using these drugs together, the impact of these drugs on hypoglycemic drugs should be fully considered, and the dosage of hypoglycemic drugs should be adjusted as appropriate to keep blood sugar stable and prevent hypoglycemia.

7. Don’t treat health care products as medicines

Health care products are not medicines and do not have exact clinical efficacy. At best, they only have auxiliary health care effects. Health care products must not be used to replace medicines. Although some health products for diabetic patients have a certain hypoglycemic effect, almost without exception, they contain illegally added Western medicine ingredients with large side effects and low prices. If taken in excess, they will be very harmful to the body.

8. Beware of hypoglycemia

The elderly themselves are susceptible to hypoglycemia, and due to neuropathy and dullness, they are prone to "asymptomatic hypoglycemia". Patients often directly enter a coma without any warning. If this happens at night It is very dangerous and often leads to severe brain damage or even death due to missed rescue opportunities. In addition, the elderly are often accompanied by cardiovascular and cerebrovascular atherosclerosis, and hypoglycemia can induce myocardial infarction and stroke. Therefore, drug treatment should be moderate and not excessive.

9. Actively treat various complications

Elderly patients with diabetes are often accompanied by various acute and chronic complications, such as cardiovascular and cerebrovascular diseases, lower limb vascular disease, diabetic nephropathy, cataracts, retinal hemorrhage, diabetic foot, etc., which bring great pain to the patients. Therefore, only controlling blood sugar It is far from enough. Various complications must be actively and comprehensively treated to improve the quality of life and longevity of elderly patients.

10. Psychotherapy cannot be ignored

Elderly patients with diabetes often have abnormal mental states due to changes in physical conditions and social roles, such as pessimism, depression, anxiety, irritability, insomnia, etc. Therefore, psychological treatment for the elderly is very necessary.

Treatment content includes disseminating knowledge about diabetes to patients and their families, encouraging patients to eliminate pessimism and treat the disease correctly; establishing a regular life order, insisting on physical exercise, and reading books and newspapers every day; helping patients enrich their lives, such as growing flowers and grass, Play chess, paint, etc.; when encountering adverse stimuli, use self-comfort to divert attention and achieve a new psychological balance.

11. Disease monitoring mainly checks blood sugar rather than urine sugar.

The renal glucose threshold of the elderly is often higher. In this case, even if the blood glucose is high, the urine glucose may still be negative, so the urine glucose result cannot better reflect the true level of blood glucose; therefore, elderly patients with diabetes should use blood glucose Monitoring is the main thing.

12. Blood sugar control goals should be relaxed appropriately.

For elderly diabetic patients with a long course of disease, multiple cardiovascular risk factors, or cardiovascular complications, strict blood sugar control may increase the incidence and mortality of cardiovascular disease. Therefore, compared with young people, the blood sugar control of elderly patients with diabetes should be appropriately relaxed - fasting blood sugar should not exceed 8.0mmol/L, postprandial blood sugar should not exceed 10.0mmol/L, and glycated hemoglobin should be maintained at around 7%; for those with complications, For those who cannot take care of themselves, fasting blood sugar <8.0mmol/L and 2-hour postprandial blood sugar <12.0mmol/L are also allowed.

Elderly patients with diabetes often have some characteristics of their own. They need to fully recognize and understand these characteristics and implement targeted individualized treatment in order to achieve better diagnosis and treatment results. Therefore, diabetic patients must follow the doctor's advice and are not allowed to use medications or change dosages without authorization.