Abstract
Diabetes mellitus may affect up to 20% of individuals over the age of 65 years. Treatment of older patients with diabetes mellitus demands careful consideration because of its prevalence and the associated multiple chronic comorbidities that require care. Currently comprising more than 12% of the United States population, the elderly population is expected to increase to 22% by the year 2040.1 There are almost 3 million of the oldest old— those individuals 85 years and older—who experience the greatest degree of medical dependency. The oldest-old group is expected to grow to 13 million by the year 2040.2
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Siegel JS. Recent and prospective trends for the elderly population and some implications for health care. In: Haynes S, Feinleib M, eds. Second Conference on the Epidemiology of Aging. DHHS (NIH) publication no. 80–969. Washington, DC: US Government Printing Office; 1980.
Guralnik JM, Fitzsimmons SC. Aging in America: a demographic perspective. Cardiol Clin. 1986; 4: 175–183.
Harris MI, Hadden WC, Knowler WC, et al. Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in U.S. population aged 20–74 years. Diabetes. 1987; 36: 523–534.
Harris MI. Epidemiology of diabetes mellitus among the elderly in the United States. Clin Geriatr Med. 1990; 6: 703–719.
Kilvert A, Fitzgerald MG, Wright AD, et al. Clinical characteristics and aetiological classification of insulin-dependent diabetes in the elderly. Q J Med. 1986; 60: 865–872.
Wachtel TJ, Tetu-Mouradjian LM, Goldman DL, Ellis SE, O’Sullivan PS. Hyperosmolarity and acidosis in diabetes mellitus: a three-year experience in Rhode Island. J Gen Intern Med. 1991; 6: 495–502.
Abbott RD, Donahue RP, MacMahon SW, Reed DM, Yano K. Diabetes and the risk of stroke. The Honolulu Heart Program. JAMA. 1987; 257: 949–952.
Wolf PA, D’Agostino RB, Belanger AJ, Kannel WB. Probability of stroke: a risk profile from the Framingham Study. Stroke. 1991; 22: 312–318.
Shlossman M, Knowler WC, Pettitt DJ, Genco RJ. Type 2 diabetes mellitus and periodontal disease. J Am Dent Assoc. 1990; 121: 532–536.
Centers for Disease Control and Prevention. Diabetes Surveillance, 1993. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Servic; 1993.
Andres R. Aging and diabetes. Med Clin North Am. 1971; 55: 835–846.
Davidson MB. The effect of aging on carbohydrate metabolism: a review of the English literature and a practical approach to the diagnosis of diabetes mellitus in the elderly. Metabolism. 1979; 28: 688–705.
Jackson RA, Blix PM, Matthews JA, et al. Influence of aging on glucose homeostasis. J Clin Endocrinol Metab. 1982; 55: 840–848.
Minaker KL. What diabetologist should know about elderly patients. Diabetes Care. 1990;13(suppl 2):34^6.
Jackson RA, Hawa MI, Roshania RD, et al. Influence of aging on hepatic and peripheral glucose metabolism in humans. Diabetes. 1988; 37: 119–129.
Chen M, Bergman RN, Pacini G, et al. Pathogenesis of age-related glucose intolerance in man: insulin resistance and decreased beta-cell function. J Clin Endocrinol Metab. 1985; 60: 13–20.
DeFronzo RA. Glucose intolerance and aging. Diabetes Care. 1981; 4: 493–501.
Lipson LG. Diabetes in the elderly: diagnosis, pathogenesis, and therapy. Am J Med. 1986; 80 (suppl 5A): 10–21.
Fink RI, Kolterman OG, Kao M, et al. The role of the glucose transport system in the postreceptor defect in insulin action associated with human aging. J Clin Endocrinol Metab. 1984; 58: 721–725.
Belfiore F, Vagnoni G, Napoli E, Rabuazzo M. Effect of aging on key enzymes of glucose metabolism in human adipose tissue. J Mol Med. 1977; 2: 89–95.
Trischitta V, Reaven GM. Evidence of a defect in insulin-receptor recycling in adipocytes from older rats. Am J Physiol 1988; 254: E38–44.
Forbes GB, Reina JC. Adult lean body mass declines with age: some longitudinal observations. Metabolism. 1977; 19: 653–663.
Sallis JF, Haskell WL, Wood PD, et al. Physical activity assessment methodology in the Five-City Project. Am J Epidemiol. 1985; 121: 91–106.
Seals DR, Hagberg JM, Allen WK, et al. Glucose tolerance in young and older athletes and sedentary men. J Appl Physiol. 1984; 56: 1521–1525.
Chen M, Bergman RN, Porte D Jr. Insulin resistance and beta-cell dysfunction in aging: the importance of dietary carbohydrate. J Clin Endocrinol Metab. 1988; 67: 951–957.
Donahue RP, Abbott RD, Reed DM, et al. Postchallenge glucose concentration and coronary heart disease in men of Japanese ancestry: Honolulu Heart Program. Diabetes. 1987; 36: 689–692.
Agner E, Thorsteinsson B, Eriksen M. Impaired glucose tolerance and diabetes mellitus in elderly subjects. Diabetes Care. 1982; 5: 600–604.
Albert MS. Cognitive function. In: Albert MS, Moss MB, eds. Geriatric Neuropsychology. New York: Guilford; 1988: 33–53.
Ciocon JO, Potter JF. Age-related changes in human memory: normal and abnormal. Geriatrics. 1988; 43 (10): 43–48.
Einstein GO, McDaniel MA. Normal aging and prospective memory. J Exp Psychol Learn Mem Cogn. 1990; 16: 717–726.
Rowe JW, Andres R, Tobin JD, et al. The effect of age on creatinine clearance in man: a cross-sectional and longitudinal study. J Gerontol 1976; 31: 513–563.
Mackenzie RA, Phillips LH II. Changes in peripheral and central nerve conduction with aging. Clin Exp Neurol 1981; 18: 109–116.
Naliboff BD, Rosenthal M. Effects of age on complications in adult onset diabetes. J Am Geriatr Soc. 1989; 27: 838–842.
Morrow LA, Halter JB. Treatment of diabetes mellitus in the elderly. In: Weir GC, ed. Joslin’s Diabetes Mellitus. 13th ed. Philadelphia: Lea & Febiger; 1993.
American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care. 1989; 12: 365–368.
Reaven GM. Beneficial effect of moderate weight loss in older patients with non-insulin-dependent diabetes mellitus poorly controlled with insulin. J Am Geriatr Soc. 1985; 33: 93–95.
Holloszy JO, Schultz J, Kursnierkiewicz J, et al. Effects of exercise on glucose tolerance and insulin resistance. Brief review and some preliminary results. Acta Med Scand Suppl. 1986; 711: 55–65.
Schneider SH, Amorosa LF, Khachadurian AK, et al. Studies on the mechanism of improved glucose control during regular exercise in type 2 (non-insulin-dependent) diabetes. Diabetologia. 1984; 26: 355–360.
Skarfors ET, Wegener TA, Lithell H, et al. Physical training as treatment for type 2 (non-insulin-dependent) diabetes in elderly men. A feasibility study over 2 years. Diabetologia. 1987; 30: 930–933.
Kennedy DI, Piper JM, Baum C. Trends in the use of oral hypoglycemic agents: 1964–1986. Diabetes Care. 1988; 11: 558–562.
Asplund K, Wiholm BE, Lithner F. Glibenclamide-associated hypoglycaemia: a report on 57 cases. Diabetologia. 1983; 24: 412–417.
Seltzer HS. Severe drug-induced hypoglycemia: a review. Compr Ther. 1979; 5 (4): 21–29.
Sonnenblick M, Shilo S. Glibenclamide induced prolonged hypoglycaemia. Age Ageing. 1986; 15: 185–189.
Minaker KL, Rowe JW, Tonino R, Pallota JA. Influence of age on clearance of insulin in man. Diabetes. 1982; 31: 851–855.
Dorfman LJ, Bosley TM. Age-related changes in peripheral and central nerve conduction in man. Neurology. 1979; 29: 38–44.
O’Brien IA, O’Hare P, Corrall RJM. Heart rate variability in healthy subjects: effect of age and the derivation of normal ranges for tests of autonomic function. Br Heart J. 1986; 5: 348–354.
Heinsimer JA, Lefkowitz RJ. The impact of aging on adrenergic receptor function: clinical and biochemical aspects. J Am Geriatr Soc. 1985; 22: 184–188.
Kadowaki T, Hagura R, Kajinuma H, et al. Chlorpropamide-induced hyponatremia: incidence and risk factors. Diabetes Care. 1983; 6: 468–471.
U’Ren RC, Riddle MC, Lezak MD, et al. The mental efficiency of the elderly person with type II diabetes mellitus. J Am Geriatri Soc. 1990; 38: 505–510.
Reaven GM, Thompson LW, Nahum D, et al. Relationship between hyperglycemia and cognitive function to older NIDDM patients. Diabetes Care. 1990; 13: 16–21.
Ouslander JG, Martin S. Assessment in the nursing home. Clin Geriatr Med. 1987; 3: 155–174.
Brock DB, Brody J A. Statistical and epidemiological characteristics. In: Andres R, Bierman EL, Hazzard WR, eds. Principles of Geriatric Medicine. New York: McGraw-Hill; 1985: 3–71.
Kemper P, Murtaugh CM. Lifetime use of nursing home care. N Engl J Med. 1991; 324: 595–600.
Tonino RP. Diabetes education. What should health care providers in long-term nursing care facilities know about diabetes? Diabetes Care. 1990; 13 (suppl 2): 55.
Harris MI, Hadden WC, Knowler WC, Bennett PH. Prevalence of diabetes and impaired glucose tolerance and plasma glucose levels in U.S. population aged 20–74 years. Diabetes. 1987; 36: 523–534.
Hing E, Sekscenski E, Strahan G. The national nursing home survey: 1985 summary for the United States. In: Vital and Health Statistics. DHHS publ. no. PHS. 1989: 89–1758. Washington, DC: Department of Health and Human Services; 1989.
Van Nostrand JF. Nursing home care for diabetics. In: Diabetes in America: Diabetes Data Compiled in 1984. DHHS publication no. 85–1468. Washington, DC: US Government Printing Office; 1985.
Edwards WS, Winn DM, Kurlantzick V, Sheridan S, Berk ML, Retchin SC. Evaluation of national health interview survey diagnostic reporting. In: Vital and Health Statistics, Series 2, No. 120. DHHS publ. no. 93–1394. Washington, DC: Department of Health and Human Services; 1994.
Mooradian AD, Osterweil D, Petrasek D, et al. Diabetes mellitus in elderly nursing home patients. A survey of clinical characteristics and management. J Am Geriatr Soc. 1988; 36: 391–396.
Lewis M, Kane RL, Cretin S, et al. The immediate and subsequent outcomes of nursing home care. Am J Public Health. 1985; 75: 758–762.
Tonino RP. What should health-care providers in long-term nursing care facilities know about diabetes. Diabetes Care. 1990; 13: 55–59.
Mooradian AD, Osterweil D, Petrasek D, Morley JE. Diabetes mellitus in elderly nursing home patients: a survey of clinical characteristics and management. J Am Geriatri Soc. 1988; 16: 391–396.
Fischer KF, Lees JA, Newman JH. Hypoglycemia in hospitalized patients. Cause and outcomes. N Engl J Med. 1986; 315: 1245–1250.
Aubert RE, Ballard DJ, Bennett PH, et al. Diabetes in Ameria. In: National Institutes of Health, National Diabetes and Digestive and Kidney Diseases. 2nd ed. NIH publ. no. 95–1468. Washington, DC: National Institutes of Health; 1995.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1997 Springer Science+Business Media New York
About this chapter
Cite this chapter
Minaker, K.L., Morrow, L.A. (1997). Treatment of Diabetes. In: Cassel, C.K., et al. Geriatric Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-2705-0_32
Download citation
DOI: https://doi.org/10.1007/978-1-4757-2705-0_32
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4757-2707-4
Online ISBN: 978-1-4757-2705-0
eBook Packages: Springer Book Archive