J Korean Diabetes.  2012 Sep;13(3):145-147.

Management of Diabetes Mellitus in Demented Patients

Affiliations
  • 1Division of Endocrinology and Geriatrics, Department of Medicine, Hallym Medical Center Hallym University School of Medicine, Seoul, Korea. hjoonyoo@gmail.com

Abstract

Management of patients with dementia differs from the management of cognitively intact patients. Although dementing illnesses are progressive, the course of dementia should be managed consistently through appropriate therapeutic efforts in order to maintain cognitive function. Irregularity of meals due to impaired cognitive function results in more frequent hypoglycemic episodes, in particular hypoglycemic coma. To prevent such episodes, less intensive glycemic targets should be set, but the risks of both hyperglycemia and hypoglycemia must be considered for each individual and the participation of caregivers is required in developing a treatment strategy. Overall, in the management of demented diabetic patients, a team approach is required and preservation of patient self-esteem is of great importance.

Keyword

Diabetes mellitus; Disease management; Dementia

MeSH Terms

Caregivers
Coma
Dementia
Diabetes Mellitus
Disease Management
Humans
Hyperglycemia
Hypoglycemia
Meals

Reference

1. Reichman WE, Cummings JL. Duthie EH, Katz PR, Malone ML, editors. Demantia. Practice of Geriatrics. 2007. 4th ed. Philadelphia: Saunders Elsevier.
2. Ko BJ, Yoo HJ. Cho KH, editor. Principles of the diagnosis and treatment of diabetes mellitus. Textbook of geriatric medicine international. 2010. Seoul: Argos;131–144.
3. Whitmer RA, Karter AJ, Yaffe K, Quesenberry CP Jr, Selby JV. Hypoglycemic episodes and risk of dementia in older patients with type 2 diabetes mellitus. JAMA. 2009. 301:1565–1572.
Article
4. Bruce DG, Davis WA, Casey GP, Clarnette RM, Brown SG, Jacobs IG, Almeida OP, Davis TM. Severe hypoglycaemia and cognitive impairment in older patients with diabetes: the Fremantle Diabetes Study. Diabetologia. 2009. 52:1808–1815.
Article
5. Yaffe K, Falvey C, Hamilton N, Schwartz AV, Simonsick EM, Satterfield S, Cauley JA, Rosano C, Launer LJ, Strotmeyer ES, Harris TB. Diabetes, glucose control, and 9-year cognitive decline among older adults without dementia diabetes and risk of cognitive decline. Arch Neurol. 2012. 06. 18. [Epub]. http://dx.doi.org/10.1001/archneurol.2012.1117.
6. Zimmerman EA, Desemone J. Ideal management of diabetes mellitus and dementia: walking a tightrope between hyperglycemia and hypoglycemia. Arch Neurol. 2010. 67:131–133.
7. Desai AK, Schwartz L, Grossberg GT. Behavioral disturbance in dementia. Curr Psychiatry Rep. 2012. 14:298–309.
Article
Full Text Links
  • JKD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr