[Diabetes in old age -- do we overstrain our patients?].
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Biomedical subjects
A Zeyfang
Publications and source records attributed to A Zeyfang.
[Structured educational programs for geriatric patients with diabetes mellitus].
Two-thirds of all diabetics are older than 60 years. Owing to the presence of multimorbidity and functional impairments, one-half of these diabetics must be considered "geriatric patients". This category of patients in particular requires a special educational program aimed at improving their situation and quality of life on the basis of good diabetic control. Currently, two educational concepts aimed in particular at elderly patients with type II diabetics and cognitive deficits are available and are described in the present paper. Education for diabetics with impairment of cognitive performance is available to such diabetics irrespective of age. The educational program: "Structured Education for Persons with Type II Diabetes in Old Age", newly developed by the Working Group Diabetes and Geriatrics of the German Diabetes Society teaches self-help skills, offers opportunities for empowerment, and has proved successful also in geriatric patients with mild cognitive deficits.
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[Healthy seniors with a normal nutritional level in the Mini-Nutritional Assessment (MNA) identified as at risk for status decline and impaired function].
Older adults are potentially vulnerable for malnutrition, risk which can be assessed by the Mini-Nutritional Assessment (MNA). To answer the question, whether the MNA can also assess healthy, normal nourished seniors and to check for correlations on functional disabilities and risk factors for functional status decline, 58 independent living, healthy elderly persons with an MNA above 24 points were studied. Different clinical and laboratory exams were performed and a comprehensive geriatric assessment was carried out. There was a non age-dependent correlation for the number of risks in the Lachs' screening, for the number of drugs taken, for the hemoglobin concentration, the level of the g- GT and for mobility assessment tested by the "Timed Up and Go Test" and the "POMA". The MNA can also distinguish in the "normal" range from 24 to 30 points between persons at risk for functional status decline or persons with slightly impaired functions.
Activities of Daily Living↗
[Anti-aging with healthy nutrition. This you can recommend!].
For a dietary anti-aging concept that "gives life to years and adds years to life" we recommend a low-fat, carbohydrate and fiber-rich diet containing plenty of fruits and vegetables and moderate amounts of protein (in particular of vegetable origin). Prolonging the fasting state by cancelling dinner is also of benefit. Five servings of fruits and vegetables (preferentially red, yellow and green) daily and whole-grain products provide sufficient amounts of vitamins C and E and the provitamin A beta-carotene, as well as secondary phytochemicals. Also to be recommended are low-fat dairy products, fish once or twice a week, little meat and eggs, and a maximum of 4-8 fl oz (1/8 to 1/4 liter) of red wine per day.
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Isolation of corpuscular components of whole blood for the determination of selenium in blood cells.
Currently, the determination of trace elements in plasma or whole blood for the evaluation of adequate supply is unsatisfactory as it does not reflect exactly the biochemical processes in the human organism. A method of isolating cell fractions was developed in order to be able to analyze these elements in the corpuscular components of the blood. The separation, which is simple to perform, makes possible a high yield of erythrocytes, thrombocytes, and polymorphnuclear and mononuclear leucocytes, as well as a high purity of the cell fractions. For the first time a precise determination of trace elements in leucocytes has become possible. The concentration in erythrocytes was not calculated but measured directly, avoiding the danger of a compounding of errors by the combination of many steps. The highest relative selenium content of an investigated reference group (n = 25) was found in the erythrocytes (39.7%), followed by the plasma (29.9%) and the thrombocytes (24.9%). The leucocytes had the lowest concentration with < 1.9% in the polymorphonuclear and < 3.7% in the mononuclear cells. A comparison of these results with the distribution of selenium in the blood compartments will show whether the use of erythrocytes resp. thrombocytes for the analysis of this element is of greater value for diagnosis and therapy than currently employed procedures.
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