Treating Diabetes in the Elderly: A Balanced Approach

Abstract

Diabetes is present in 16% of the age group over 65 years old. These patients present a special treatment challenge in light of the marked morbidity and mortality associated with diabetes. Recent studies show the importance of glycemic control in preventing or minimizing the severity of microvascular complications for all diabetic patients, thus mandating aggressive diabetes treatment programs to fit the different needs of elderly patients. After appropriate screening and diagnosis, individual treatment goals are established and treatment is begun through diet, exercise, and weight loss. Diabetes education provides the foundation for an effective treatment program. New drugs for treating diabetes have expanded treatment options, especially for type II diabetes. The different action mechanisms of these new medications allow better individualized treatment. More options are now available for combining newer agents with insulin or for monotherapy with insulin (both conventional and intensified). Most impaired elderly patients require support from family, social services, and health care agencies for successful implementation of a diabetes treatment program.