Diabetes in Elder People

Diabetes in the elderly can present particular problems of care, and in general these increase with advancing age. As with the rest of the adult population, most diabetes in this age group is Type 2, and over half of people affected by this form of the syndrome are aged over 60. Symptoms can be vague in older people and it is suspected that many cases go undiagnosed. Also, elderly people often have established complications, which can sometimes be quite severe, at the time of diagnosis.

Diabetic Foot Disease is particularly common. Elderly people are at greater risk of severe hypoglycaemia, which can prove fatal. For this reason, strict control of glycaemia is usually not the best option for this age group. There can be many problems affecting the management of diabetes in the elderly and choice of treatment has to be very carefully assessed on an individual basis. Problems include coexisting medical conditions and complications, intellectual impairment which may make it difficult for the person to understand the nature of diabetes and its treatment, psychological disorders and depression, and social isolation.

Sometimes, especially if the person lives alone, the best course of treatment from a medical point of view cannot be implemented and a compromise needs to be reached. Arthritis causes many problems in the management of diabetes although devices have been developed to help overcome some of these, for example to make it easier to inject insulin and monitor blood glucose. Ideally, elderly people should receive plenty of home support from family and friends, as well as from healthcare professionals, and should have ready access to specialist services such as chiropody. Unfortunately, for many, the level of support is far from ideal due in part to the pressure on the Health Service and the fact that many elderly people live alone. However, voluntary organizations including local branches of Diabetes UK are often able to provide some support and help.

• Diabetes and pregnancy
• Gestational diabetes
• Diabetes in children
• Diabetes in minority group people