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Chapter 32 - Diabetes Mellitus
- from Section III - Care of the Elderly by Organ System
- Edited by Jan Busby-Whitehead, University of North Carolina, Chapel Hill, Samuel C. Durso, The Johns Hopkins University, Maryland, Christine Arenson, Thomas Jefferson University, Philadelphia, Rebecca Elon, The Johns Hopkins University School of Medicine, Mary H. Palmer, University of North Carolina, Chapel Hill, William Reichel
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- Book:
- Reichel's Care of the Elderly
- Published online:
- 30 June 2022
- Print publication:
- 21 July 2022, pp 395-406
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Summary
Diabetes mellitus (DM) is a dominant chronic disease in the older adult population in the United States as well as in many other countries of the world. The prevalence of DM in the future is only expected to grow with the increase in the population of adults aged 65 and over, the prevalence of obesity, and physical inactivity. Clinicians are faced with many unique challenges when caring for this older diabetic population. The clinician’s major challenges are (1) to avoid symptoms and complications of hyper- and hypoglycemia, (2) to minimize or delay micro- and macrovascular complications, if possible, and (3) to maximize daily functioning. Underlying these challenges is the realization that the geriatric population is a heterogeneous one. Goals of care and treatment decisions may vary, depending more on the patient’s functional abilities and on other comorbidities or coexisting geriatric syndromes, and less on the age of the patient. This chapter will focus on specific aspects of diabetes care in the older adult.
Chapter 30 - Diabetes mellitus in the older adult
- from Section III - Care of the elderly by organ system
- Edited by Jan Busby-Whitehead, Christine Arenson, Thomas Jefferson University, Philadelphia, Samuel C. Durso, The Johns Hopkins University School of Medicine, Daniel Swagerty, University of Kansas, Laura Mosqueda, University of Southern California, Maria Fiatarone Singh, University of Sydney, William Reichel, Georgetown University, Washington DC
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- Book:
- Reichel's Care of the Elderly
- Published online:
- 05 June 2016
- Print publication:
- 23 June 2016, pp 421-435
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Summary
Diabetes mellitus (DM) is a dominant chronic disease in the older adult population in the United States as well as in many other countries of the world. The prevalence of DM in the future is only expected to grow with the increase in the population of older adults, the prevalence of obesity, and physical inactivity. Clinicians are faced with many unique challenges when caring for this older diabetic population. The clinician’s major challenges are 1) to avoid symptoms and complications of hyper- and hypoglycemia, 2) to minimize or delay micro- and macrovascular complications, if possible, and 3) to maximize daily functioning. Underlying these challenges is the realization that the geriatric population is a heterogeneous one. Goals of care and treatment decisions may vary, depending more on the patient’s functional abilities and on other comorbidities or co-existing geriatric syndromes, and less on the chronological age of the patient. After a diagnosis of diabetes in the older adult, diabetes care requires lifestyle modifications and glycemic control strategies, in addition to prevention and management of cardiovascular, eye, and foot disease.
Contributors
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- By Phillip L. Ackerman, Soon Ang, Susan M. Barnett, G. David Batty, Anna S. Beninger, Jillian Brass, Meghan M. Burke, Nancy Cantor, Priyanka B. Carr, David R. Caruso, Stephen J. Ceci, Lillia Cherkasskiy, Joanna Christodoulou, Andrew R. A. Conway, Christine E. Daley, Janet E. Davidson, Jim Davies, Katie Davis, Ian J. Deary, Colin G. DeYoung, Ron Dumont, Carol S. Dweck, Linn Van Dyne, Pascale M. J. Engel de Abreu, Joseph F. Fagan, David Henry Feldman, Kurt W. Fischer, Marisa H. Fisher, James R. Flynn, Liane Gabora, Howard Gardner, Glenn Geher, Sarah J. Getz, Judith Glück, Ashok K. Goel, Megan M. Griffin, Elena L. Grigorenko, Richard J. Haier, Diane F. Halpern, Christopher Hertzog, Robert M. Hodapp, Earl Hunt, Alan S. Kaufman, James C. Kaufman, Scott Barry Kaufman, Iris A. Kemp, John F. Kihlstrom, Joni M. Lakin, Christina S. Lee, David F. Lohman, N. J. Mackintosh, Brooke Macnamara, Samuel D. Mandelman, John D. Mayer, Richard E. Mayer, Martha J. Morelock, Ted Nettelbeck, Raymond S. Nickerson, Weihua Niu, Anthony J. Onwuegbuzie, Jonathan A. Plucker, Sally M. Reis, Joseph S. Renzulli, Heiner Rindermann, L. Todd Rose, Anne Russon, Peter Salovey, Scott Seider, Ellen L. Short, Keith E. Stanovich, Ursula M. Staudinger, Robert J. Sternberg, Carli A. Straight, Lisa A. Suzuki, Mei Ling Tan, Maggie E. Toplak, Susana Urbina, Richard K. Wagner, Richard F. West, Wendy M. Williams, John O. Willis, Thomas R. Zentall
- Edited by Robert J. Sternberg, Oklahoma State University, Scott Barry Kaufman, New York University
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- Book:
- The Cambridge Handbook of Intelligence
- Published online:
- 05 June 2012
- Print publication:
- 30 May 2011, pp xi-xiv
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8 - Diabetes Mellitus in the Older Adult
- Edited by Christine Arenson, Jan Busby-Whitehead, University of North Carolina, Chapel Hill, Kenneth Brummel-Smith, Florida State University, James G. O'Brien, University of Louisville, Kentucky, Mary H. Palmer, University of North Carolina, Chapel Hill, William Reichel, Georgetown University, Washington DC
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- Book:
- Reichel's Care of the Elderly
- Published online:
- 19 May 2010
- Print publication:
- 09 February 2009, pp 79-88
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Summary
INTRODUCTION
Diabetes mellitus (DM) is a dominant chronic disease of older adults in the United States as well as in many other countries of the world. The prevalence of DM in the future is only expected to grow with the increase in the population of older adults, the prevalence of obesity, and physical inactivity. Clinicians will be faced with many unique challenges when caring for this older diabetic population. The clinician's major challenges are 1) to avoid symptoms and complications of hyper- and hypoglycemia, 2) to minimize or delay micro- and macrovascular complications, if possible, and 3) to maximize daily functioning. Underlying these challenges is the realization that the geriatric population is a heterogeneous one. Goals of care and treatment decisions may vary. These may depend less on the chronological age of the patient, although issues of life expectancy must be considered especially in the very old, but more so on the patient's functional abilities and on other comorbidities or coexisting geriatric syndromes. This chapter will focus on specific aspects of diabetes care in the older adult.
EPIDEMIOLOGY
An estimated 10.3 million people, or 20.9% of those 60 years of age or older, in the United States are afflicted with DM, the majority of whom have type 2 disease. Approximately half of Americans with diabetes are 60 years of age or older with an approximately even split between men and women. DM is more prevalent in minority groups.