Diabetes in the elderly: Diagnosis, pathogenesis, and therapy

The prevalence of diabetes mellitus increases with age; it occurs in approximately 10 percent of Americans 60 years of age and in 16 to 20 percent of those 80 years old. Type II diabetes mellitus is primarily found in the elderly, and it is estimated that an additional 20 percent of the elderly popu...

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Bibliographic Details
Published inThe American journal of medicine Vol. 80; no. 5; pp. 10 - 21
Main Author Lipson, Loren G.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 16.05.1986
Subjects
Adolescent
Adult
Aged
Aging
Blood Glucose
Cognition
Collagen - metabolism
Diabetes Mellitus, Type 2 - diagnosis
Diabetes Mellitus, Type 2 - epidemiology
Diabetes Mellitus, Type 2 - etiology
Diabetes Mellitus, Type 2 - therapy
Diet
Female
Glucose - metabolism
Humans
Hyperglycemia - epidemiology
Insulin - metabolism
Insulin - therapeutic use
Insulin Resistance
Insulin Secretion
Kidney - metabolism
Middle Aged
United States
United States
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Summary:The prevalence of diabetes mellitus increases with age; it occurs in approximately 10 percent of Americans 60 years of age and in 16 to 20 percent of those 80 years old. Type II diabetes mellitus is primarily found in the elderly, and it is estimated that an additional 20 percent of the elderly population has age-associated hyperglycemia, which may be part of a spectrum between normality and type II diabetes. The diabetic group is at risk for both microvascular and macrovascular complications of diabetes, whereas the group with the hyperglycemia of aging may be at risk for macrovascular-type complications. Thus, 40 percent of our senior population has abnormal carbohydrate tolerance and is at risk for diabetic-type chronic complications. The basis for both the diabetic state as well as for the hyperglycemia of aging is probably multifactorial—involving both altered insulin secretion and altered insulin action. Unique problems arise in treating older diabetic patients. Physiologic changes occurring during normal aging, age-associated pathologic processes, the increased prevalence of other chronic diseases, and polypharmacy must all be considered in selecting appropriate therapy for these patients. A rational approach for the maintenance of glucose homeostasis is presented for older patients with diabetes.
ISSN:0002-9343
1555-7162
DOI:10.1016/0002-9343(86)90533-4