Management of cardiovascular disease risk factors in older adults with type 2 diabetes mellitus: 2002-2012 literature review.

摘要: Type 2 diabetes mellitus (DM) is one of the most common chronic conditions in older adults and often accompanied by comorbidities geriatric syndromes. The management cardiovascular disease risk factors with DM important to clinicians. literature was reviewed from 2002 2012 provide an American Geriatrics Society expert panel evidence base for updating making new recommendations improving care type DM. This review includes only domains blood pressure, lipid control, glycemic use aspirin. Over last 10 years, randomized controlled trials (RCT) designed study different pressure treatment targets did not find that intensive systolic control (<130 mmHg) resulted lower rates myocardial infarction mortality than less-intensive control. There are risks side effects achieving less 120 mmHg. Lipid-lowering statins effective reducing events middle-aged adults, but data on niacin fibrates limited. Trials other lipid-lowering agents do evaluate outcomes treating lipids low-density lipoprotein cholesterol targets. No RCTs drugs enrolled significant numbers aged 80 or without Three major investigated reductions primary endpoints, reported greater glycosylated hemoglobin 6%. Two recently published were benefits aspirin individuals Neither trial found significantly fewer endpoints groups. Overall, few comorbidities. More research needed clinicians effectively customize because heterogeneity health status, comorbidities, duration disease, frailty functional differences life expectancy.