Case Study on Multiple Daily Injection Therapy Education for Elderly Diabetes Patients Aged 80 and Over

Generally, task performance and cognitive function begin to decline from around the age of 80, and dementia prevalence rises steeply thereafter. Nevertheless, multiple daily injections (MDIs) are still prescribed for many patients aged ≥ 80. MDI can improve glycemic control compared with a single injection or none; however, the risks of hypoglycemia and adverse events also increase. Therefore, when considering MDI in very old adults, a comprehensive assessment of physical function, performance status, and cognition is essential. In patients with cognitive impairment, initiating therapy with a longacting insulin and gradually transitioning to MDI may enhance adherence. Above all, expansion of community and social resources is needed to support patients who cannot self-inject.