中国老年2型糖尿病诊疗措施专家共识（2018年版）

Expert consensus of the diagnosis and treatment measures for the Chinese elderly patients with type 2 diabetes （2018 Edition）

21世纪是我国人口老龄化的快速进展时期。国家统计局2018年公布的数据显示，2017年我国老年（960岁）人口占总人口的17．3％（2．4亿），预计到2050年，我国老年人口比例将超过30％。其中20％以上的老年人是糖尿病患者（95％以上是2型糖尿病），45％以上的老年人处于糖尿病前期状态。糖尿病直接或间接造成的人体损伤，已成为我国居民死亡的主要危害因素之一。

According to the national survey data over the past five years,there are about 50.16 million elderly diabetic patients （≥60 years old） in China.With the increase in the total number of the elderly,this number will be expected to increase.Among the elderly patients,most of them are newly diagnosed,and are associated with a number of risk factors for cardiovascular diseases at the time of initial diagnosis.Those who were with young-onset have a long-term clinical course,and often complicated with diabetic chronic complications and potential organ dysfunctions.Most of the elderly diabetic patients in China are with poor glycemic control.The diabetes-related complications have become one of the major reasons for the senile death.It is well accepted that early diagnosis and reasonable treatment could reduce the occurrence of diabetic complications,and the disability and fatal cardiovascular and cerebrovascular events.Thus,it is recommended,in the consensus,to conduct a comprehensive assessment of the glycemic control,metabolic cardiovascular risk factors,diabetes complications,multiple organ functions of the elderly patients,as well as their intelligence and physical fitness.Personalized control targets on blood glucose,pressure,lipids,uric acid and body weight would be established based on the assessment of each patient and consideration of the balance between benefits and risks in order to achieve the goal of early detection,early diagnosis,early treatment and early target reaching.Moreover,it is also recommended,in the consensus,to focus on the basic treatments （diets,exercises,self-monitoring and management）,initiate suitable hypoglycemic drugs with complementary mechanisms when needed,and take into consideration of management of multiple cardiovascular risk factors and drug usage together with the caution of mutual interactions of multiple drugs.