Sinn oder Unsinn der Gewichtsreduktion beim älteren Diabetiker

 

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Zusammenfassung

Lebensstilinterventionen, einschließlich der Gewichtsreduktion beim übergewichtigen und adipösen Patienten, stellen die Grundlage in der Diabetestherapie dar und zeigen in jedem Lebensalter günstige Effekte auf das kardiometabolische Risikoprofil. Strikte diätetische Maßnahmen werden für ältere Patienten grundsätzlich nicht empfohlen, da das Risiko zur Entwicklung einer Malnutrition erhöht ist mit entsprechend ungünstigen Auswirkungen auf geriatrische Syndrome, Komorbiditäten und die Mortalität. Ein ungewollter Gewichtsverlust bei Diabetes mellitus kann Ausdruck einer Stoffwechselentgleisung mit Hyperglykämie und Glukosurie sein, wie auch infolge von Arzneimittelnebenwirkungen auftreten. Der vorliegende Übersichtsartikel nimmt Bezug auf die Prävalenz der Adipositas und des Diabetes mellitus im höheren Lebensalter, die Korrelation zwischen Body-Mass-Index (BMI) und Mortalität sowie die Gewichtseffekte der antidiabetischen Therapie.

Abstract

Life-style interventions, including weight reduction as a basic therapeutic tool in the treatment of overweight and obese patients with type 2 diabetes, result in favourable cardiometabolic effects for all age groups. In general, strict dietary recommendations are not recommended for elderly patients due to a high risk for malnutrition and related geriatric syndromes, co-morbidities and mortality. Unintended weight loss in diabetic patients might be due to detoriated hyperglycaemia with glucosuria, or side-effects of medication. The present review summarizes recently published studies about the prevalence of obesity and diabetes in the elderly population, the correlation of Body Mass Index (BMI) to mortality and weight effects of glucose lowering medication.

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