Management of elderly diabetic patients in the subacute care setting

Type 2 diabetes is a commonly encountered condition in the subacute care setting. The results of the landmark UK prospective studies have confirmed that aggressive glycemic and blood pressure control delayed diabetes-related microvascular and macrovascular complications and significantly improved diabetic outcomes. Within the past few years, new drugs have been developed to address both aspects of the type 2 diabetes syndrome: insulin resistance and insulin secretory defect. C-peptide analysis may be useful to predict a successful response to therapy with insulin sensitizers or the need to initiate therapy with insulin or insulin stimulators. The issues regarding the general approach to elderly diabetics and the strategies of dealing with diabetic complications encountered in the subacute care program are discussed and updated. It is hoped that diabetic management can be improved and that suggested alternate therapies can be used in the subacute care facilities.