ResultsWe found 176 studies and firstly check them by the ti-tles and abstracts to see if they were fulfilling the crite-ria. Only 20 that fulfilled inclusion criteria were in-cluded, fully reviewed and summarized in this reviewarticle.The elderly population is very heterogeneous, con-taining within itself a very large interindividual varia-tions. Physiological process of aging depends on both ge-netic and environmental factors, as well as the presenceof disease can significantly accelerate the aging process.One should distinguish the concept of chronological (cal-endar) and physiological (cellular) age. Biological age es-timate is based on assessment of cardiovascular, respira-tory system as well as renal function8. The population ofelderly people are on one side of the»spectrum«»oldyoungsters«with preserved physiological function andfunctional capacity above expected levels for age and, onthe other hand the same»spectrum«hard empowered se-niors (frailty syndrome), which are weak, exhausted anddependent on the help of others9. The concept of popula-tion heterogeneity in older people with diabetes is thefoundation of an individualized care for elderly diabetics.This individualized approach involves synergism ofnonpharmacologic and pharmacologic measures. Non--pharmacological counseling aims for lifestyle changes(diet, exercise, self-control), and pharmacological meansprescribing medications. When choosing medications forelderly diabetics, one should take into account side ef-fects of some (hypoglycemia, weight gain, fluid retention,gastrointestinal disorders, flatulence), contraindicationsor appropriate dose adjustment for individual patients(hypoxia, congestive heart failure, renal impairment)10but also adjust prescription to the patient’s personalchoice, prognosis and comorbidity, always taking into ac-count the quality of life. In»biologically younger«elderly,with longer life expectancy goals of glycemic control areequal as in adults aged <65 years, and the same recom-mendations for nonsmoking, regular exercise, maintain-ing a normal BMI, target blood pressure and hyperlipi-demia apply11. But in those»biologically older«targetHbA1c is shifted towards higher proportionally with in-creasing age, reduced functional abilities, cognitive ca-pacities and ability for self-care.The therapeuticgoals of glycemic control, blood pres-sure, and hyperlipidemia in elderly diabetics according toKirkman MS and colleagues12are shown in Table 1.
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