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Brittle diabetes in the elderly.

S J Benbow1, A Walsh, G V Gill

  • 1University Clinical Department of Medicine, University Hospital Aintree, Liverpool L9 1AE, UK.

Journal of the Royal Society of Medicine
|November 3, 2001
PubMed
Summary

Elderly brittle diabetes, characterized by severe glycemic instability, presents differently than in younger patients, often stemming from multiple causes. This condition requires increased attention as insulin use rises among older adults.

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Area of Science:

  • Endocrinology
  • Geriatrics
  • Diabetes Mellitus Research

Background:

  • Brittle diabetes significantly disrupts the lives of patients, caregivers, and healthcare teams.
  • While typically affecting younger individuals (15-30 years), brittle diabetes can occur in older populations.
  • Understanding the unique characteristics and causes of brittle diabetes in the elderly is crucial due to increasing insulin use in this demographic.

Purpose of the Study:

  • To investigate the specific characteristics and perceived causes of brittle diabetes in elderly patients.
  • To compare the presentation and etiology of brittle diabetes in the elderly versus younger individuals.

Main Methods:

  • A questionnaire was distributed to all UK hospital diabetic clinics for adults.
  • Data were collected from 55 elderly patients (age ≥ 60 years) meeting criteria for brittle diabetes.
  • Information was further gathered through research nurse visits to relevant clinics.

Main Results:

  • The mean age of the 55 elderly patients was 74 years, with 71% being female.
  • The primary forms of instability were mixed glycemic instability (44%), recurrent ketoacidosis (29%), and recurrent hypoglycemia (27%).
  • In two-thirds of cases, the diabetes care team identified multiple origins for the brittleness; memory or behavioral issues were rare.

Conclusions:

  • Elderly brittle diabetes exhibits distinct patterns of instability and causation compared to younger patients.
  • The findings suggest that brittle diabetes in the elderly may be increasingly encountered.
  • Further research is warranted to address the complexities of managing brittle diabetes in older adults.

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