臺灣預估於2025 年將邁入超高齡社會，老年糖尿病患者的盛行率勢必大幅成長，而因老化伴隨生理機能改變、認知能力退化、共病症複雜與多重用藥相關交互作用，使得血糖控制更加複雜。目前雖已有數篇治療指引根據病人特徵提供hemoglobin A1c（HbA1c）建議目標，然仍缺乏臨床實證支持治療的益處與用藥選擇建議。在此情形下如何依據病人特徵與個人偏好以制訂治療目標，並在提供可用選項後與病人共同合作擬定治療策略，成為老年糖尿病人用藥照護的首要任務。之後仍應隨病程進展、認知／生活能力衰退與預期壽命定期修正治療目標與藥品選用，以提升該族群之醫療照護品質與用藥配合度。

 

It’s expected Taiwan will enter the ultra-senior society in 2025 and the prevalence of elderly patients with diabetes will increase significantly. Aging related physiologic change, declining cognitive, multiple co-morbidity and drug interaction would make blood glucose control more complex. Although several guidelines have been proposed different hemoglobin A1c (HbA1c) suggestions according to patient clinical characteristics, it’s still lack of good quality of clinical evidence to support clinical benefits of aggressive intervention and which medication was better. In such circumstances, how to develop therapeutic goals according to clinical characteristic and patient preference, and cooperate with patients to develop therapeutic strategy after offering medication options would be the first task of pharmaceutical care in elderly diabetic mellitus. Thereafter, it should periodically revise therapeutic goals and medication choosing according to disease progression, declining cognitive/capacity and expecting life to improve quality of care and medication adherence in such population.