[Relationships between activities of daily living and glucose metabolism in geriatric patients with type 2 diabetes mellitus].

In higher age, various diseases are more frequently present and occur in combination, with diabetes mellitus representing the comorbidity seen most frequently. Within the framework of a retrospective study, it has been evaluated whether the degree of metabolic compensation has an influence on the activities of daily life in geriatric patients after an acute event and following rehabilitation treatment. For this purpose over a period of 27 months (01/02/2000 - 03/31/2002), diabetic patients of a Saxonian geriatric center (n = 644, mean age 77.86 years/SD 7.115, 30.3% males) were examined before, directly after, and 2 - 3 years after rehabilitation. Independent of age, rehabilitation resulted in a significant increase in activities of daily living (ADL, Barthel index); however, after 2 - 3 years these values decreased again, not depending on age, but they remained significantly above the baseline values (multiple comparison of mean values). The values at the time of dismissal did not depend on metabolic parameters. The result of the rehabilitation treatment checked by means of a questionnaire 2 - 3 years after dismissal showed clear advantages for those patients having a near-normal compensation of metabolism. When HbA1c was below 7% at the time-point of the geriatric rehabilitation the Barthel index score in the questionnaire was found to be significantly higher (multiple comparisons of mean values) than in patients with a HbA1c of 7% or higher. With increasing age, the danger of hypoglycemia was seen to be significantly elevated (Fisher's exact test).