Impact of frailty in older patients with diabetes mellitus: An overview

Endocrinol Nutr. 2016 Jun-Jul;63(6):291-303. doi: 10.1016/j.endonu.2016.01.004. Epub 2016 Mar 9.
[Article in English, Spanish]

Abstract

Diabetes and frailty are two conditions that frequently occur concurrently and are increasingly prevalent in the older patient. We review the concept, epidemiology and consequences of frailty, and the implications of the presence of frailty in the management of diabetes. Frailty is associated with decreased quality of life, a risk of falls, new or increased disability, hospitalization, and increased mortality. All of these factors affect the management of diabetes in older patients. It is important to rule out frailty in all diabetic patients aged >70 years; if frailty is suspected, a comprehensive and multidisciplinary medical and functional assessment of the patient should be conducted to develop an individualized treatment plan. This plan should include nutritional measures, physical activity, and education on self-care and diabetes; drugs should not be used without a clear indication. Antihyperglycemic drugs that may cause excessive weight loss and/or are associated with a high risk of hypoglycemia should be avoided.

Keywords: Diabetes; Fragilidad; Frailty; Hiperglucemia; Hyperglycemia; Older people; Personas mayores; Sarcopenia.

Publication types

  • Review

MeSH terms

  • Aged
  • Combined Modality Therapy
  • Comorbidity
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / physiopathology
  • Diabetes Mellitus / therapy
  • Fatigue / epidemiology*
  • Fatigue / etiology
  • Female
  • Frail Elderly*
  • Humans
  • Hypoglycemic Agents / adverse effects
  • Male
  • Middle Aged
  • Muscle Weakness / diagnosis
  • Muscle Weakness / epidemiology*
  • Patient Education as Topic
  • Physical Examination
  • Psychology
  • Quality of Life
  • Risk
  • Self Care
  • Thinness / epidemiology*
  • Thinness / etiology
  • Weight Loss / drug effects

Substances

  • Hypoglycemic Agents