Sign up for our complimentary
weekly e-journal

Main Newsletter
Mastery Series
Therapy Series
Bookmark and Share | Print Article | Items for the Week Previous | All Articles This Week | Next
This article originally posted and appeared in  Aging & DiabetesPublic HealthIssue 652

How Should We Treat the Elderly with Diabetes?

More than one-quarter of all adults over age 65 have diabetes but there is little research on how to treat the disease in older adults....

Fewer studies on the best ways to treat elderly patients with diabetes has resulted in doctors lacking a strong understanding of how diabetes affects this population. The American Diabetes Association is hoping to change that.

The ADA recently convened a group of doctors and other experts to study the issue in greater depth. The fruit of their labor, a report titled "Diabetes in Older Adults: A Consensus Report," will be published later this year in Diabetes Care and The Journal of the American Geriatrics Society.

"This is a major effort to address this challenge," said Dr. Hermes Florez, a member of the committee and head of the division of epidemiology at the University of Miami Miller School of Medicine. "With life expectancy being five to 10 years more than before and the increased prevalence of this disease, we have to prepare ourselves."

According to the ADA research paper, the number of cases of diagnosed diabetes in the elderly is projected to more than quadruple by 2050. Why do older adults face such a high risk of developing diabetes?

According to the report, the body becomes more resistant to insulin with age. What's more, the part of the pancreas that synthesizes insulin functions less effectively over time.

Florez, who is also the deputy director of the Geriatrics Research Education and Clinical Center within the Miami VA Healthcare System, stated that, "The mean age of the patients I see is about 80." "Some of them are quite functional and very proficient. Others are very frail."

Diabetes can cause a myriad of complications. The ADA report found that older adults who have diabetes are at a higher risk of limb amputations, heart attacks, vision problems and kidney failure than diabetes patients in any other age group. The risk grows even higher for patients over 75.

Additionally, older adults with diabetes are twice as likely as other older adults to have cognitive problems like Alzheimer's disease and dementia, according to the paper. They face a higher risk of depression, hearing and vision problems, as well as falling. "That could be a devastating event leading to a hip fracture and a prolonged rehabilitation," Florez said.

Still, questions linger about how to treat diabetes in older patients, largely because little research has been done.

"The exclusion of older, and especially frail older, participants from most traditional randomized controlled trials of diabetes interventions has left us with large gaps in our knowledge of how best to address diabetes in the age-group with the highest prevalence rates," the research group wrote in its report.

Florez said older adults may have been left out of the clinical research because the pharmaceutical companies wanted to avoid possible complications. In addition, few geriatric specialists and researchers were trained to look out for diabetes, he said.

Once a diagnosis is made, treating diabetes in older adults can be a challenge. Older patients tend to eat less, so it is difficult to control the disease through diet modification. Treating the disease can be even more challenging for older adults living in a nursing home, where meals can be erratic and there are high levels of employee turnover.

Researchers are working on studies that will address some of those questions.

Presented at the 2012 AHA Meeting. 



Bookmark and Share | Print | Category | Home

This article originally posted 15 November, 2012 and appeared in  Aging & DiabetesPublic HealthIssue 652

Past five issues: Diabetes Clinical Mastery Series Issue 251 | Issue 791 | Diabetes Clinical Mastery Series Issue 250 | GLP-1 Special Editions July 2015 | Issue 790 |

2015 Most Popular Articles:

Self-Monitoring of Blood Glucose: The Patient's Perspective
Posted July 10, 2015
The Impact of Glucagon-Like Peptide 1 Receptor Agonists on Weight Reduction
Posted July 10, 2015
Diet That Mimics Fasting Appears to Slow Aging
Posted July 03, 2015
Vitamin D3 Supplementation and Weight Loss Prevent Cancer in Older Women
Posted July 10, 2015
Evaluation of Cellphone Application that Records Readings from Glucometer
Posted July 10, 2015
Important Advances in Type 1 Diabetes Research
Posted June 25, 2015
Can the Insulin Patch Become a Reality?
Posted July 03, 2015
New Evidence Suggests Pioglitazone Reduces Dementia Risk 42%
Posted July 03, 2015
Metformin May Increase Mortality in Advanced CKD among Type 2 Patients
Posted July 10, 2015
GLP-1 Receptor Agonists Reduce Bone Loss During Weight Loss
Posted July 17, 2015

Browse by Feature Writer & Article Category.
A. Lee Dellon, MD | Aaron I. Vinik, MD, PhD, FCP, MACP | Beverly Price | Charles W Martin, DD | Derek Lowe, PhD | Dr. Brian Jakes, Jr. | Dr. Fred Pescatore | Dr. Tom Burke, Ph.D | Eric S. Freedland | Evan D. Rosen | Ginger Kanzer-Lewis | Greg Milliger | Kristina Sandstedt | Laura Plunkett | Leonard Lipson, M.A. | Louis H. Philipson | Maria Emanuel Ryan, DDS, PhD | Marilyn Porter, RD, CDE | Melissa Diane Smith | Michael R. Cohen, RPh, MS, ScD, FASHP | Paul Chous, M.A., OD | Philip A. Wood PhD | R. Keith Campbell, Professor, B.Pharm, MBA, CDE | Richard K. Bernstein, MD | Sheri R. Colberg PhD | Sherri Shafer | Stanley Schwartz, MD, FACP, FACE | Steve Pohlit | Steven V. Edelman, M.D. | Timothy S. Hollingshead |

Cast Your Vote
Would you be interested in a urine test strip product that measures microalbumin and creatinine levels to determine kidney failure risk in your patients?

CME/CE of the Week
Dr. Michael Miller, Dr. Sergio Fazio, and Dr. Roger Blumenthal

Category: Cardiology