Diabetes – diagnostic and therapeutic differences in the elderly
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 5
Abstract
The incidence of diabetes mellitus increases with age, and its diagnosis and treatment in older people presents a challenge. There are a number of age-related changes in carbohydrate metabolism. These include progressive detriments in glucose-induced insulin secretion and resistance to insulin-mediated glucose disposal. Diabetes is often missed in the elderly because its presenting symptoms may be nonspecific. The principles of diabetes management in elderly patients are similar to those in younger patients, but with special considerations linked to the increased prevalence of comorbidities and relative inability to tolerate adverse effects of medication and hypoglycemia. Several recent trials suggest that tighter glucose control reduces long-term complications in diabetic patients; however, outcomes of tight blood sugar control in the elderly are not known. The goals of glycemic control in elderly patients should be individualized and formulated after consideration of their clinical and functional status and life expectancy. Aggressive glycemic control is less important than avoiding hypoglycemia and achieving a good quality of life. The first step in therapy for glycemic control is diet and exercise, although such measures are often limited in the elderly. Pharmacologic options for the treatment of elderly patients with diabetes mellitus are the same as in younger adults; however, treatment considerations differ in the elderly due to changes in renal and hepatic function and various other clinical conditions.
Authors and Affiliations
Magdalena Walicka, Ewa Czerwińska
Keywords
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