Sammanfattning
Introduction: Selecting treatment goals for elderly with
diabetes in nursing homes is challenging due to their age and
health-related vulnerability to serious complications, such as
hypoglycemia.
Aim: To discuss treatment goals for blood glucose regulation
and the risk of hypoglycemia among elderly with diabetes in
nursing homes using national and international evidence based
guidelines.
Methods: A literature search was conducted to identify
national and international evidence based guidelines and
recommendations for treatment goals for blood glucose and
their relation to the risk of hypoglycemia among elderly with
diabetes.
Results: The literature indicates that the recommended
level for glycated hemoglobin (HbA1c) among elderly with diabetes
varies between 7% and 8.5%. In addition, both national
and international evidence based guidelines emphasize the
individualization of treatment goals. The Norwegian diabetes
guidelines, however, lack specific treatment goals for elderly
patients with diabetes. International guidelines, on the other
hand, give recommendations that relate the risk of hypoglycemia
to the potential benefits of tighter blood glucose regulation.
Conclusion: Selecting optimal treatment goals for blood
glucose regulation among elderly with diabetes is about finding
a balance between the minimum risk of hypoglycemia
and the minimum discomfort and morbidity as a result of
hyperglycemia.