Diabetes Mellitus
Diabetes presents atypically in older individuals. Upon diagnosis of diabetes or prediabetes, diabetic education, dietary education, exercise, and weight loss are appropriate interventions. Treatment goals for blood glucose in diabetes take into consideration health status, cognitive and physical function, and resources for care. In particular, the provider must work with the patient to balance the benefits of tighter glucose control on macrovascular and microvascular complications with the risk of adverse effects, particularly hypoglycemia. Efforts to reduce diabetes-related mortality should focus on macrovascular complications, including heart disease and stroke. Older diabetics are at particular risk for the geriatric syndromes of persistent pain, urinary incontinence, cognitive impairment, depression, injurious falls, and polypharmacy. Older adults with diabetes benefit greatly from person-centered, age-friendly care focused on optimizing function and minimizing adverse events and provided by an interprofessional team.
