УСПЕХИ ГЕРОНТОЛОГИИ • 2014 • Т. 27 • № 3 © Коллектив авторов, 2014 УДК 616.379-008.64-08-053.9 P. Weber, D. Weberova, H. Meluzinova HOW TO APPROACH TO THE THERAPY OF DIABETES IN THE ELDERLY Department of Internal Medicine, Geriatrics and Practical Medicine; Faculty Hospital and Masaryk University, 20, Jihlavskб, Brno 62500, Czech Republic; e-mail: p.weber@fnbrno.cz In gerontology diabetes mellitus (DM) is clinically the most frequent and extremely serious metabolic disorder. <...> With increasing life expectancy physicians are called upon to manage diabetes in the elderly more often. <...> Apart from genetic predisposition and an environmental infl uence, nutritional habits, modern lifestyle, stress and minor physical activity are of particular importance. <...> Treatment options for T2DM in the elderly are diet, physical activity, various oral anti-diabetic drugs and insulin. <...> At the start of treatment should primarily take into account: patient’s age; self-suffi ciency; late micro- and macro-vascular complications; social status; nutritional assessment (incl. dental status); other handicaps — psychic, motoric, visual and aural. <...> Especially in frail, elderly patients, there should be less emphasis on strict glycaemic control than on avoiding malnutrition and hypoglycemia and achieving the best possible quality of life. <...> Therapy of DM in this population is tightly connected with signifi cant risks of microand macrovascular complications on one hand, and possible problems of the treatment (e.g. hypoglycemia) with intensive control on the other hand. <...> To realize a comprehensive approach to therapy of diabetes in the old age a holistic approach with main aim improving quality of life is necessary. <...> Key words: diabetes mellitus T2, advanced age, multi-morbidity, geriatric syndromes, poly-pharmacy, hypo glycemia, treatment, oral anti-diabetic drugs, insulin Future perspective WHO estimates that more than 346 million people in the world are diabetics. <...> Geriatrization of medicine and diabetic care will become everyday reality. <...> The increase of DM is tightly connected with growing tendency of overweight, obesity, unhealthy nutritional habits, inactive, mainly sedentary, lifestyle and socioeconomic disadvantages. <...> Appropriate prevention of diabetes risk factors should be integrated into population approaches to three main non-communicable diseases (cardiovascular disease, chronic <...>