Diabetes Mellitus in Older Adults

Abstract

The prevalence of diabetes mellitus increases with age and causes significant morbidity and poor quality of life in older adults. To review the current literature on the diagnosis and management of diabetes in the elderly, the relevant manuscripts were identified through a MEDLINE (2000-September 1, 2010) search of the English literature. The key phrase used was diabetes in older adults or diabetes in the elderly. The literature search was limited to core clinical journals that have accessible full texts. A total of 480 manuscripts were reviewed. Managing diabetes in older adults is a challenging task. Some features of the disease are unique to the older patient. Several new antidiabetic agents are now available for clinical use, and yet very few clinical trials have been carried out in this age group. For many older adults, maintaining independence is more important than adherence to published guidelines to prevent diabetes complications. The goals of diabetes care in older adults are to enhance quality of life without subjecting the residents to inappropriate interventions.

Factors associated with diabetes among the elderly receiving care at a specialized gerontology-geriatric outpatient clinic

“…The growth in the proportion of elderly persons has been accompanied by an increase in the prevalence of chronic non-communicable diseases, among which diabetes mellitus stands out for its high morbidity and mortality rates, especially in more advanced age groups 1 . According to the American College of Cardiolog y Foundation and the American Heart Association, diabetes affects 18% of elderly persons and 50% of type 2 diabetes sufferers are aged over 60 2 .…”

Is Renal Impairment Concealed in Elderly Diabetics????

“…Our study showed that elderly diabetics had significantly lower BMI compared to younger diabetics and this lower BMI in the elderly could be due to malnutrition, age-related changes in taste and appetite suppression or/and age-related weight reduction [18][19][20]. Simultaneously, adherence to lifestyle modification and better insulin sensitivity could also play a role in lowering BMI.…”

Nutrition Considerations for the Growing Population of Older Adults With Diabetes

“…28 However, it would be inappropriate to stereotype all older adults as being passive regarding their self-care or incapable of achieving good control. 29 Instead, it may be the case that older adults face a greater self-care load than when they were younger, creating more challenges for daily decision making and execution of management tasks.…”

“…However, research suggests that older adults are more likely to develop diabetes-related complications and at a more accelerated rate. 4 Ty pic a l d iab e te s t re at ment plans involving dietary restrictions, increasing physical activity, and pharmaceutical interventions may, in fact, lead to additional health risks in older adults. Hypoglycemia, undesirable weight loss, and falls may contribute to undesirable health outcomes.…”

“…4 Role playing, label reading, menu selection demonstrations, and menu writing can prove to be valuable activities during the nutrition education process.…”