Title:Clinical Management of Diabetes Mellitus in the Older Adult Patient
Volume: 13
Issue: 3
Author(s): Nana Yaw Adu-Sarkodie*
Affiliation:
- VA Maryland Health Care System (VAMHCS), Geriatrics and Extended Care (GEC), Home Based Primary Care Program (HBPC), Loch Raven VA Community Living and Rehabilitation Center, 3900 Loch Raven Blvd, Baltimore, Maryland 21218,United States
Keywords:
Diabetes complications, diabetes management, elderly/older adult, hypo- and hyper-glycemia, insulin therapy, lifestyle
modification, Type 1/Type 2 diabetes.
Abstract: Background: In 2009, approximately 40 million people were 65 years or older. The majority
of people over the age of 65 have at least one chronic medical condition. In 2002-2003, the following
medical conditions were common among older adults: hypertension (51%), arthritis (48%), heart
disease (31%), cancer of any type (21%), and diabetes (16%). The cost of diabetes care, both direct
and indirect, was $245 billion in 2012. Fifty-nine percent of the direct medical cost was for the population
aged 65 and over.
Methods: A literature review was conducted with a review of mostly peer-reviewed publications from
1987 – 2016 in the preparation of this manuscript.
Results: Management goals include control and minimization of hypo- and hyperglycemia and their
symptoms, evaluation and treatment of associated risks for atherosclerotic and micro-vascular disease;
evaluation and treatment of related complications; support for diabetes self-management and education;
maintenance or improvement of the patient's general health status.
Conclusion: Providers, patients, caregivers and family members should be vigilant to recognize and
manage, micro - and macro-vascular diseases quickly, to prevent increased incidence in morbidity and
mortality, as well as medical costs of diabetes care attributed to this age group.
