Treatment Of Diabetes In The Elderly

Treatment Of Diabetes In The Elderly.
Better diabetes therapy has slashed rates of complications such as consideration attacks, strokes and amputations in older adults, a uncharted study shows. "All the event rates, if you look at them, everything is a lot better than it was in the 1990s, dramatically better," said reading author Dr Elbert Huang, an associate professor of nostrum at the University of Chicago. The study also found that hypoglycemia, or low blood sugar - a lesser effect of medications that control diabetes - has become one of the top problems seen in seniors, suggesting that doctors may desideratum to rethink drug regimens as patients age.

The findings, published online Dec 9, 2013 in JAMA Internal Medicine, are based on more than 72000 adults elderly 60 and older with genre 2 diabetes. They are being tracked through the Kaiser Permanente Northern California Diabetes Registry. Researchers tallied diabetic complications by era and length of time with the disease. People with personification 2 diabetes, the most common form of the disease, have too much sugar in the blood.

It's estimated that ruthlessly 23 million people have type 2 diabetes in the United States, about half of them older than 60. Many more are expected to exhibit diabetes in coming years. In general, complications of diabetes tended to go from bad to worse as people got older, the study found. They were also more hard-hearted in people who'd lived with the disease longer. Heart disease was the chief complication seen in seniors who'd lived with the infirmity for less than 10 years.

For every 1000 seniors followed for a year, there were about eight cases of ticker disease diagnosed in those under age 70, about 11 cases in those in their 70s, and roughly 15 cases for those ancient 80 and older. Among those aged 80 or older who'd had diabetes for more than a decade, there were 24 cases of pity disease for every 1000 people who were followed for a year. That's a big chuck from just a decade ago, when a prior study found rates of heart disease in elderly diabetics to be about seven times higher - 182 cases for every 1000 colonize followed for a year.

Heart disease isn't the only predicament to see drastic declines. Dangerous episodes of high blood sugar have plunged about 10-fold since 2002, while amputations appear to be about three times lower. Things are so much better, in fact, that it's the care itself that's now become one of the dominating reasons seniors with diabetes get sick. Hypoglycemia due to plummeting blood sugar - characterized by weakness, hub palpitations, trembling, sweating, trouble speaking and nervousness - is now the third most common nonfatal complication of diabetes in long-term diabetics venerable 70 and older, the researchers found.

So "Hypoglycemia is a side effect of therapy and it's not a bad thing. It's now more common than kidney failure or amputation. That means the side effects of curing are now more common than the things we're trying to prevent. An expert who wasn't involved with the den praised its focus on older adults, who make up about half of those living with diabetes in the United States.

And "We are getting more and more caring about the complications that occur in older adults with ongoing treatment," said Dr Gisele Wolf-Klein, maestro of geriatric education at the North Shore-LIJ Health System in New Hyde Park, NY Wolf-Klein, who has conscious rates of hypoglycemia in nursing home residents, says it's an underappreciated problem. "We be in want of to understand that older diabetics may be continuing to induce the same medication they always took, but they've completely changed their lifestyle," said Wolf-Klein.

For example, many seniors competition to get enough to eat during the day, something doctors may not think to ask about. Metabolism also slows with age, Wolf-Klein said, making drugs that lop off blood sugar especially effective in this population prices. "We have to remember that because people are living much longer, the way you treat diabetes in a 40-year-old is accepted to be very different than the way you treat diabetes in an older patient.