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REVIEW ARTICLE
Year : 2011  |  Volume : 15  |  Issue : 2  |  Page : 75-90

Management of hyperglycemia in geriatric patients with diabetes mellitus: South Asian consensus guidelines


1 Department of Endocrinology, Excel Center, Guwahati, India
2 Bharti Hospital and BRIDE, Karnal, India
3 Amrita Institute of Medical Sciences, Kochi, India
4 Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
5 National Hospital of Sri Lanka, Colombo, Sri Lanka
6 Providence Endocrine and Diabetes Specialty Centre, Trivandrum, India
7 Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
8 Norvic International Hospital, Kathmandu, Nepal
9 St. Johns Medical College, Bangalore, India
10 Osmania Medical College, Hyderabad, India
11 University of Medicine 2, Yangon, Myanmar
12 BIRDEM Hospital, Dhaka, Bangladesh

Correspondence Address:
Manash P Baruah
Excel Center, Ulubari, Guwahati - 781 007, Assam
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.81935

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Asia is home to four of the world's five largest diabetic populations, two of them being South Asian nations, namely, India and Pakistan. This problem is compounded by a substantial rise in the elderly population in Asian countries. On the other hand, the heterogeneous health condition and multiple co-morbidities make the care of chronic disease in the elderly a challenging task. The aim of the South Asian Consensus Guidelines is to provide evidence-based recommendations to assist healthcare providers in the rational management of type 2 diabetes mellitus in the elderly population. Current Guidelines used systematic reviews of available evidence to form its key recommendations. No evidence grading was done for the purpose of this manuscript. The clinical questions of the guidelines, the methodology of literature search, and medical writing strategy were finalized by consultations in person and through mail. The South Asian Consensus guideline emphasizes tailoring of glycemic goals for patients based on age, co-morbid conditions especially that of cardiovascular system, risk of hypoglycemia, and life expectancy. It also recommends cautious use of available pharmacotherapy in geriatric patients with diabetes. The primary principle of diabetes therapy should be to achieve euglycemia, without causing hypoglycemia. Appropriate use of modern insulins and oral drugs, including incretin mimetics will help physicians achieve this aim.


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