guidelines for diabetes management in elderly

🔥+ guidelines for diabetes management in elderly 06 Jul 2020 Two patients were not able to successfully use the continuous glucose monitoring system (CGMS). The study included patients with type 2 diabetes with a history ...

guidelines for diabetes management in elderly Type 2 diabetes can occur at any age but is most common in older adults. Read about the type 2 diabetes symptoms, risk factors, treatments, and more.

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Medically reviewed by Peggy Pletcher, MS, RD, LD, CDE on February 27, 2017 Written by Adrienne Santos-Longhurst

Type 2 diabetes is the most common form of diabetes. Read on to learn some of the key facts and statistics about the people who have it and how to manage it.

Risk factors

Many risk factors for type 2 diabetes include lifestyle decisions that can be reduced or even cut out entirely with time and effort. Men are also at slightly higher risk of developing diabetes than women. This may be more associated with lifestyle factors, body weight, and where the weight is located (abdominally versus in the hip area) than with innate gender differences.

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  • older age
  • excess weight, particularly around the waist
  • family history
  • certain ethnicities
  • physical inactivity
  • poor diet

Prevalence

Type 2 diabetes is increasingly prevalent but also largely preventable. According to the Centers for Disease Control and Prevention (CDC), type 2 diabetes accounts for about 90 to 95 percent of all diagnosed cases of diabetes in adults. The CDC also gives us the following information:

In general

  • Research suggests that 1 out of 3 adults has prediabetes. Of this group, 9 out of 10 don't know they have it.
  • 29.1 million people in the United States have diabetes, but 8.1 million may be undiagnosed and unaware of their condition.
  • About 1.4 million new cases of diabetes are diagnosed in United States every year.
  • More than one in every 10 adults who are 20 years or older has diabetes. For seniors (65 years and older), that figure rises to more than one in four.
  • Cases of diagnosed diabetes cost the United States an estimated $245 billion in 2012. This cost is expected to rise with the increasing diagnoses.

In pregnancy and parentingAccording to the CDC, 4.6 to 9.2 percent of pregnancies may be affected by gestational diabetes. In up to 10 percent of them, the mother is diagnosed with type 2 diabetes just after the pregnancy. The rest of these women have a 35 to 60 percent chance of developing type 2 diabetes within 10 to 20 years. This risk decreases if the woman leads an active lifestyle and maintains an ideal weight.

A child has a 1 in 7 chance of developing diabetes if one parent was diagnosed before age 50. If the parent was diagnosed after age 50, the child has a 1 in 13 chance. The child's risk may be greater if the mother has diabetes. If both parents have diabetes, the child's risk is about 50 percent.

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Certain racial or ethnic groups have higher rates of prediabetes and type 2 diabetes. The risk is higher even after adjusting for other factors. Statistics from The National Institute of Diabetes and Digestive and Kidney Diseases and CDC show the risks for different groups:

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In the United States, type 2 diabetes is more prevalent for certain groups than for Caucasians. These people include:

  • Native Americans
  • African Americans
  • Hispanics
  • Asian Americans

Compared to non-Hispanic white adults in the United States, Asian Americans have a nine percent higher risk of diabetes. Non-Hispanic Blacks have a 13.2 percent higher risk. Hispanics have a 12.8 percent higher risk, but this varies depending on national lineage. Currently, the rates of diagnosed diabetes are:

  • 8.5 percent for Central and South Americans
  • 9.3 percent for Cubans
  • 13.9 percent for Mexican Americans
  • 14.8 percent for Puerto Ricans

American Indian adults in southern Arizona have the world’s highest rate of type 2 diabetes. One in three are currently diagnosed.

In children

Type 2 diabetes is rare for children of all racial and ethnic backgrounds. Still, it has higher rates in many minority groups than in Caucasians. This is particularly true for Asian Pacific Islanders ages 10 to 19 years. Across all ethnic groups though, type 2 diabetes is increasing around the age of puberty.

Age

The risk of developing type 2 diabetes increases with age.

The number of children diagnosed with type 2 diabetes is growing due to more overweight youth. Still, it is much less common in children and young adults than it is in older people.

For example, consider data from the CDC: Among children 10 years and younger, the rate of new cases in 2008–2009 was 0.8 per 100,000. For ages 10 to 19 years, this rate was 11 per 100,000. Comparatively, about 12.3 percent of all adults age 20 or older have diabetes. And 25.9 percent adults 65 years or older have diabetes. That’s much higher than the 0.26 percent of children 19 and under.

Adults ages 40 to 59 comprise the world’s age group with the highest diabetes rates. According to one study, this is expected to shift to adults ages 60 to 79 by 2030.

Worldwide

Type 2 diabetes is on the rise worldwide. The International Diabetes Federation reports that more than 400 million people were living with diabetes as of 2015. The World Health Organization (WHO) estimates that 90 percent of people around the world who have diabetes have type 2.

In 2012, diabetes caused an estimated 1.5 million deaths. More than eight of every 10 of them occurred in low- and middle-income countries. In developing nations, more the 1 last update 06 Jul 2020 than half of all diabetes cases go undiagnosed. WHO anticipates that worldwide deaths from diabetes will double by 2030. In 2012, diabetes caused an estimated 1.5 million deaths. More than eight of every 10 of them occurred in low- and middle-income countries. In developing nations, more than half of all diabetes cases go undiagnosed. WHO anticipates that worldwide deaths from diabetes will double by 2030.

Prevention

Both type 2 diabetes and its side effects can often be prevented or delayed. The most cost-effective methods include getting regular physical activity and maintaining a healthy weight. This means following a healthy diet plan. Regular visits to a healthcare provider are also essential. Medication may be necessary as for 1 last update 06 Jul 2020 well. Catching complications early allows for intervention, education, and referral to a specialist when needed.Both type 2 diabetes and its side effects can often be prevented or delayed. The most cost-effective methods include getting regular physical activity and maintaining a healthy weight. This means following a healthy diet plan. Regular visits to a healthcare provider are also essential. Medication may be necessary as well. Catching complications early allows for intervention, education, and referral to a specialist when needed.

Weight

Keeping a healthy weight is important. The Diabetes Prevention Program found that weight loss and increased physical activity reduced the chance of prediabetes turning into type 2 diabetes by 58 percent. For people 60 years or older, the reduction was 71 percent. For overweight people, losing five to seven percent of body weight through exercise and healthy eating could prevent the onset of type 2 diabetes.

Monitoring

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Medication

The drug metformin was found to reduce the risk of diabetes onset by 31 percent, particularly in younger and heavier prediabetic adults.

Complications and effects

Problems from type 2 diabetes are common and can be severe. People with diabetes have twice the risk of death of any cause compared to people of the same age without diabetes. In 2014, diabetes was listed as the seventh leading cause of death in the United States. The contribution of diabetes to death may be underreported on death certificates.

Side effects of type 2 diabetes can include:

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  • heart disease
  • stroke
  • hypertension
  • blindness and eye problems
  • kidney disease
  • nervous system complications
  • amputations
  • foot problems
  • dental disease
  • pregnancy complications
  • mental health problems, such as depression
  • skin issues

Heart problems

WHO estimates that 50 percent of people with diabetes die of cardiovascular disease, such as heart disease the 1 last update 06 Jul 2020 and stroke. The American Diabetes Association reports that more than 71 percent of U.S. adults with diabetes had hypertension or used medication to treat hypertension.WHO estimates that 50 percent of people with diabetes die of cardiovascular disease, such as heart disease and stroke. The American Diabetes Association reports that more than 71 percent of U.S. adults with diabetes had hypertension or used medication to treat hypertension.

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There were 7,686 cases of diabetic retinopathy in the United States in 2010. Diabetes is the leading cause of newly diagnosed adult blindness for people between the ages of 20 and 74 years.

Kidney problems

Diabetes was also the primary cause of kidney failure in 44 percent of all new cases in 2011. During the same year, it was also reported that 228,924 people began treatment for kidney failure due to diabetes.

Sensation problems and amputation

Diabetes causes mild loss of sensation in the extremities in as many as 70 percent of adults who have it. Amputations of lower extremities may eventually be necessary, especially for people with blood vessel disease. More than 60 percent of all nontraumatic amputations of lower limbs occur in people with diabetes. Approximately 73,000 lower-limb amputations were performed in diabetics age 20 and older.

Birth defects

Uncontrolled diabetes during pregnancy can increase the chance of:

  • birth defects
  • large babies
  • other issues that can be dangerous to the baby and the mother

Mental health effects

People with diabetes are twice as likely to suffer from depression as people without diabetes.

Medically reviewed by Peggy Pletcher, MS, RD, LD, CDE on February 27, 2017 Written by Adrienne Santos-Longhurst
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