Nutritional Management of the Elderly Person with Diabetes

Abstract

Current European recommendations are based on studies in younger age groups, which have then been extrapolated to the elderly. The quality of evidence for the specific effects of dietary intervention in older age groups is poor.The most recent European recommendations for adults with diabetes are shown in Table 10.1 (15). They emphasise energy balance and weight control, and recognise a wide variation in carbohydrate intake as being compatible with good diabetic control. The target of nutritional management is to help optimise glycaemic control and reduce the risk of cardiovascular disease and nephropathy. However, the quality of life of the individual person must be considered when defining nutritional objectives and health care providers must achieve a balance between the demands of metabolic control, risk factor management, patient well-being and safety. Compliance with all treatment modalities is likely to be compromised by increasing physical and mental disabilities, which occur more frequently in the ageing population.If beneficial changes to the diet of an elderly person with diabetes are to be achieved, access to dietetic services is needed. The following topics should be considered: body weight, physical activity and the specific micronutrient composition of the diet including carbohydrates, protein, alcohol, sodium, vitamins and minerals.

Challenges and Management Strategies in the Nutrition of Older People with Diabetes

“…3,4 We come across a broad spectrum of diabetes in the older age group, which consists of the prediabetes group, a small but increasing population of older adults patients with type 1 diabetes (T1D), older adult patients with newly diagnosed T2D, and transient forms of diabetes secondary to an intercurrent or underlying disease or treatment. 5,6 In older adults, an unrecognized, gradual rise in blood glucose levels can occur, which is worsened by the physiological changes associated with aging and can contribute to the development of overt T2D. Some factors include increased fasting hepatic glucose production, decreased beta-cell mass, changes in beta-cell secretory function, changes in body composition, and increased insulin resistance.…”

“…3 4 We come across a broad spectrum of diabetes in the older age group, which consists of the prediabetes group, a small but increasing population of older adults patients with type 1 diabetes (T1D), older adult patients with newly diagnosed T2D, and transient forms of diabetes secondary to an intercurrent or underlying disease or treatment. 5 6…”