2021 is coming to an end
As of December 20, 2021, among all the academic papers, guidelines, and expert consensus published in 198 journals of the Chinese Medical Series in 2021, the top rankings for Most Read and Most Download in the whole year are " "Guidelines for Diagnosis and Treatment of Diabetes in the Elderly in China (2021 Edition)", its cumulative readings and downloads have exceeded 120,000 times
The number of elderly diabetic patients in China ranks first in the world, and the management of elderly diabetic patients urgently needs to be standardized.
The latest epidemiological survey shows that the prevalence of elderly diabetes in China is 30.
2%, and the number of patients is 35.
5 million, accounting for 1/of the global elderly diabetic patients.
Ranked first in the world
It is worth noting that the rate of blood glucose control in elderly diabetic patients in China is only 43.
4%, and 28.
0% of elderly patients have a history of hypoglycemia
With the increasing demand for diabetes management in the elderly in China, the management of elderly diabetic patients urgently needs to be standardized.
There is no authoritative guideline on the management of elderly diabetes in China before 2021.
Therefore, it is urgent to formulate corresponding measures for the special population of elderly diabetic patients in China.
In response to clinical needs, multidisciplinary experts work together to cooperate.
Diabetes and its complications and comorbidities are important chronic diseases that affect the quality of life and life expectancy of the elderly
Senile diabetes has its own characteristics in terms of pathogenesis, clinical features, and complications, and requires highly individualized treatment strategies
Based on the current accumulation of basic and clinical research in the field of senile diabetes, and the continuous advent of drugs to control diabetes and complications, there is an urgent need to formulate guidelines for standardized management of senile diabetes based on existing evidence
The National Center for Geriatrics, the Branch of Geriatrics of the Chinese Medical Association, and the Diabetes Professional Committee of the Chinese Geriatric Health Association organized more than 50 people from diabetes, endocrinology, geriatrics, neurology, nephrology, ophthalmology, rehabilitation medicine, and sports nutrition.
Well-known domestic experts and scholars in many fields have worked together to jointly write the "Guidelines for Diagnosis and Treatment of Diabetes in the Elderly in China (2021 Edition)"
Professor Guo Lixin of Endocrinology, National Center for Geriatric Medicine, Beijing Hospital and Professor Xiao Xinhua, Department of Endocrinology, Peking Union Medical College Hospital, served as co-corresponding authors of the guidelines
The guidelines were simultaneously published in the authoritative journals "Chinese Journal of Geriatrics" and "Chinese Journal of Diabetes" in January 2021
The guide is rich and detailed, and proposes management strategies for the treatment of elderly diabetic patients.
The "Guidelines for Diagnosis and Treatment of Diabetes in the Elderly in China (2021 Edition)" have been systematically searched to collect the latest high-level domestic and foreign research evidences related to elderly diabetes, especially a large number of high-quality Chinese Evidence, a detailed discussion of issues related to elderly diabetes, including the epidemiology of elderly diabetes and its complications, clinical features of elderly diabetes, comprehensive health assessment of elderly diabetic patients, blood sugar management, atherosclerotic cardiovascular disease ( Arteriosclerotic cardiovascular disease (ASCVD) risk factor management, acute and chronic complications management, etc.
, and the management of comorbid diseases in elderly diabetic patients and the management of special circumstances were discussed in depth
In addition, the guidelines also emphasize that elderly diabetic patients are highly heterogeneous and need to adopt a stratified and highly individualized management strategy.
It proposes a blood glucose management path suitable for elderly diabetes (including non-insulin treatment path and insulin treatment path) and a simple treatment concept.
It also elaborated the "de-strengthening treatment strategy" proposed by the expert committee, emphasizing the need to balance the benefit-risk ratio of treatment, and the issuance of the guidelines is conducive to the "fine management" of elderly diabetes and the improvement of clinical outcomes
According to the characteristics of elderly diabetic patients, it is clear that the health status of diagnosis, treatment and treatment varies greatly among individuals, often accompanied by varying degrees of cognitive dysfunction and complex underlying diseases.
Therefore, the "Guidelines for Diagnosis and Treatment of Diabetes in the Elderly (2021 Edition)" clearly pointed out that the elderly should be dealt with.
Patients undergo a comprehensive evaluation, and a stratified and individualized management strategy is adopted based on the results of the evaluation
At the same time, the guidelines still propose the need to combine the particularities of elderly diabetic patients, including the high risk of hypoglycemia in elderly patients, poor cognitive function, high risk of malnutrition, many complications and comorbidities, increased postprandial blood glucose and multiple medications are common The priority is to choose hypoglycemic drugs with low risk of hypoglycemia, simplicity and high compliance, small impact on patients’ weight, no increase in the safety of patients’ important organs, effective reduction of postprandial blood glucose and low risk of drug interactions
For elderly diabetic patients who must be combined with insulin to control their blood sugar satisfactorily, the insulin regimen should be simplified as much as possible, emphasizing that the insulin treatment regimen needs to be "de-enhanced
In addition, the guidelines also point out the need to pay attention to the management of comorbid diseases of diabetes in the elderly, and strengthen the screening and supportive treatment of comorbid diseases such as heart failure, osteoporosis, sarcopenia and frailty, falls, cognitive impairment and oral diseases in elderly patients
For special situations such as in-hospital management, home management and management of elderly care institutions for elderly diabetic patients, the guidelines also give corresponding guidelines for reference and reference by clinicians
The guidelines standardize the diagnosis and treatment of senile diabetes and contribute to a healthy China strategy.
Based on the latest domestic and international clinical and scientific evidence, the Guidelines for the Diagnosis and Treatment of Diabetes in the Elderly (2021 Edition) put forward new treatment concepts and paths for the diagnosis and treatment of senile diabetes in combination with China’s actual conditions.
It is scientific, time-effective and operable.
It is a programmatic document guiding the standardized diagnosis and treatment of senile diabetes in China at this stage
Once the guide was published, it attracted widespread attention and received wide acclaim in the industry
The issuance of the "Guide" can guide and help clinicians to carry out comprehensive and full-cycle standardized and comprehensive management of elderly diabetic patients, help improve the clinical outcomes of elderly diabetic patients, and contribute to the healthy China strategy