Clinical Management of Diabetes Mellitus in the Older Adult Patient

摘要

Background: In 2009, approximately 40 million people were 65 years or older. The majority of people over the age of 65 have at least one chronic medical condition. In 2002-2003, the following medical conditions were common among older adults: hypertension (51), arthritis (48), heart disease (31), cancer of any type (21), and diabetes (16). The cost of diabetes care, both direct and indirect, was $245 billion in 2012. Fifty-nine percent of the direct medical cost was for the population aged 65 and over. Methods: A literature review was conducted with a review of mostly peer-reviewed publications from 1987 - 2016 in the preparation of this manuscript. Results: Management goals include control and minimization of hypo- and hyperglycemia and their symptoms, evaluation and treatment of associated risks for atherosclerotic and micro-vascular disease; evaluation and treatment of related complications; support for diabetes self-management and education; maintenance or improvement of the patient's general health status. Conclusion: Providers, patients, caregivers and family members should be vigilant to recognize and manage, micro - and macro-vascular diseases quickly, to prevent increased incidence in morbidity and mortality, as well as medical costs of diabetes care attributed to this age group.