We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Particularidades no manejo do diabetes em crianças e idosos.
- Authors
Matheus, Alessandra S. M.; Cobas, Roberta A.
- Abstract
This review aimed to present and discuss the particularities in managing diabetes in two distinct populations, children and the elderly, through a review of the main guidelines in the area and literature addressing important aspects of each age group which impacts on therapeutic decisions. The management of diabetes in children and the elderly has some points in common. Both populations are very heterogeneous clinical and psychological characteristic in which the individualization of treatment is critical to achieve therapeutic success. Both are vulnerable to the risk of hypoglycemia and extreme hyperglycemia and in most cases their social and family support are essential to the suitable treatment. Therapeutic targets in children recommended by the International Society of Pediatric and Adolescent Diabetes (ISPAD) and followed by the Brazilian Society of Diabetes are level of glycated hemoglobin (A1c) < 7.5% for all under 18 years but always emphasizing the need to avoid severe hypoglycemia and ensure normal development and growth. The treatment is diet, physical activity and insulin since diagnosis in cases of type 1 diabetes. Metformin associated or not with insulin can be used in cases of type 2 diabetes. For the elderly, objectives and treatment goals varies depending on the presence of comorbidity, frailty, cognitive deficit, life expectancy and social/familial support. Thus, A1c targets can range from 6.5% to 8.5-9.0% and should always be individualized. The choice of medication must consider the duration of diabetes, patient’s weight, presence of symptoms, glycemic control, the potential of the drug in reducing blood glucose, its extra-glycemic effects, its safety profile, tolerability, dosage and cost.
- Publication
Revista Hospital Universitário Pedro Ernesto (HUPE), 2015, Vol 14, Issue 4, p39
- ISSN
1983-2567
- Publication type
Article
- DOI
10.12957/rhupe.2015.20056