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Glukosestoffwechsel im fortgeschrittenen Lebensalter

Glucose metabolism in older patients

  • Schwerpunkt: Stoffwechselerkrankungen
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Zusammenfassung

Spezifische Therapieempfehlungen für den Diabetes mellitus im Alter (>65 Jahre) basieren vornehmlich auf epidemiologischen Studien und dem geriatrischen Assessment der funktionalen Gesundheit. Darüber hinaus gibt es altersassoziierte Störungen des Glukosemetabolismus und der Glukosehomöostase, die für die Pathophysiologie des Diabetes mellitus im Alter von Bedeutung sind. Der Übersichtbeitrag konzentriert sich auf diese Veränderungen der Stoffwechselprozesse und ihre Bedeutung für eine spezialisierte Diabetologie im Alter. Dabei werden eine Zunahme der Insulinresistenz, die altersbedingte β‑zelluläre Sekretionsstörung und Veränderungen der Inkretinausschüttung beschrieben. Zusätzlich wird die klinische Relevanz dieser Effekte vor dem Hintergrund des zentralen geriatrischen Syndroms der Sarkopenie sowie der antidiabetischen Arzneimitteltherapie diskutiert.

Abstract

Current guidelines for specialized treatment of diabetes mellitus in the elderly (>65 years old) are primarily based on epidemiologic studies and geriatric assessment of functional health. Yet, age-dependent alterations of glucose metabolism and homeostasis are highly relevant to the pathophysiology of diabetes in the elderly. In this review, we focus on age-related alterations in metabolic pathways and their relevance for the specialized diabetic care in the elderly. We review the role of increasing insulin resistance, age-related β‑cell dysfunction and incretin secretion. The clinical relevance of these effects will also be discussed in regard to the central geriatric syndrome of sarcopenia and antidiabetic drug therapy.

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Author information

Authors and Affiliations

  1. Lehrstuhl für Altersmedizin, Klinik für Innere Medizin und Geriatrie am Franziskushospital Aachen, Uniklinik RWTH Aachen, Morillenhang 27, 52074, Aachen, Deutschland

    T. Laurentius, M. Freitag, J. Eitner &  L. C. Bollheimer

  2. Apotheke, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland

    M. Freitag & A. Eisert

  3. Institut für Pharmakologie und Toxikologie, Uniklinik RWTH Aachen, Wendlingweg 2, 52074, Aachen, Deutschland

    A. Eisert

  4. Institut für Klinische Chemie, Laboratoriumsmedizin und Transfusionsmedizin, Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Professor-Ernst-Nathan-Straße 1, 90419, Nürnberg, Deutschland

    T. Bertsch

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  6. L. C. Bollheimer
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Correspondence to L. C. Bollheimer.

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Interessenkonflikt

T. Laurentius, M. Freitag, J. Eitner, A. Eisert, T. Bertsch und L.C. Bollheimer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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H. Lehnert, Lübeck

C.C. Sieber, Nürnberg

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Laurentius, T., Freitag, M., Eitner, J. et al. Glukosestoffwechsel im fortgeschrittenen Lebensalter. Internist 60, 133–140 (2019). https://doi.org/10.1007/s00108-018-0542-y

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