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Glycemic control in elderly people with diabetes
1Department of Family Medicine, State University of New York, Stony Brook.
Clinics in Geriatric Medicine
|November 1, 1990
Summary
Diabetic complications may stem more from hyperlipidemia, obesity, and hypertension than high blood sugar. Rigorous glucose control is often unwarranted, especially in the elderly, due to severe adverse effects.
Area of Science:
- Endocrinology
- Metabolic Disorders
- Geriatrics
Background:
- Diabetes mellitus presents with multiple metabolic derangements beyond hyperglycemia.
- Hyperlipidemia, obesity, and hypertension are significant comorbidities in diabetes.
- The contribution of these factors to diabetic complications may outweigh that of elevated blood glucose.
Purpose of the Study:
- To evaluate the role of hyperglycemia in diabetic complications.
- To assess the evidence supporting rigorous hypoglycemic treatment.
- To examine the risks and benefits of pharmacologic therapy, particularly in the elderly.
Main Methods:
- Review of existing literature and prospective randomized controlled studies.
- Analysis of the heterogeneity of elderly diabetic ambulatory patients.
- Consideration of dietary therapy and pharmacologic interventions.
Main Results:
- The role of hyperglycemia in diabetic complications is uncertain.
- Limited evidence supports aggressive glucose-lowering strategies.
- Adverse effects of pharmacologic therapy can be severe, especially in the elderly.
Conclusions:
- Individualized therapy is crucial for elderly diabetic patients due to heterogeneity.
- Dietary modifications are essential for managing obesity and related complications.
- Pharmacologic hypoglycemic therapy is generally unwarranted for asymptomatic individuals.
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