Treatment Of Diabetes In The Elderly

Treatment Of Diabetes In The Elderly.
Better diabetes therapy has slashed rates of complications such as compassion attacks, strokes and amputations in older adults, a untrodden 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 cramming author Dr Elbert Huang, an associate professor of medication 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 shortage 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 superannuated 60 and older with strain 2 diabetes. They are being tracked through the Kaiser Permanente Northern California Diabetes Registry. Researchers tallied diabetic complications by maturity and length of time with the disease. People with genus 2 diabetes, the most common form of the disease, have too much sugar in the blood.

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

For every 1000 seniors followed for a year, there were about eight cases of nub disease diagnosed in those under age 70, about 11 cases in those in their 70s, and roughly 15 cases for those elderly 80 and older. Among those aged 80 or older who'd had diabetes for more than a decade, there were 24 cases of bravery disease for every 1000 people who were followed for a year. That's a big fall-off 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 consumers 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 curing itself that's now become one of the noteworthy reasons seniors with diabetes get sick. Hypoglycemia due to plummeting blood sugar - characterized by weakness, enthusiasm palpitations, trembling, sweating, trouble speaking and uneasiness - 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 chaste thing. It's now more common than kidney failure or amputation. That means the side effects of healing are now more common than the things we're trying to prevent. An expert who wasn't involved with the sanctum 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 troubled about the complications that occur in older adults with ongoing treatment," said Dr Gisele Wolf-Klein, executive of geriatric education at the North Shore-LIJ Health System in New Hyde Park, NY Wolf-Klein, who has laboured rates of hypoglycemia in nursing home residents, says it's an underappreciated problem. "We indigence to understand that older diabetics may be continuing to away the same medication they always took, but they've completely changed their lifestyle," said Wolf-Klein.

For example, many seniors strife 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 diminish blood sugar especially cogent in this population taller. "We have to remember that because people are living much longer, the way you treat diabetes in a 40-year-old is prospering to be very different than the way you treat diabetes in an older patient.