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Brittle diabetes in the elderly.

D N Griffith1, J S Yudkin

  • 1Academic Unit of Diabetes and Endocrinology, Whittington Hospital, London, UK.

Diabetic Medicine : a Journal of the British Diabetic Association
|July 1, 1989
PubMed
Summary

Brittle diabetes, characterized by major blood glucose swings, affects elderly patients differently than younger ones. Senile dementia can significantly contribute to metabolic control instability in older adults.

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Area of Science:

  • Geriatrics
  • Endocrinology
  • Metabolic Disorders

Background:

  • Brittle diabetes, defined by significant metabolic control fluctuations, is commonly observed in younger individuals.
  • Limited research exists on brittle diabetes presenting in elderly patient populations.

Observation:

  • This study examines six elderly patients experiencing brittle diabetes.
  • Key differences in etiology and management strategies compared to younger patients were noted.

Findings:

  • Elderly patients may benefit from less stringent glycemic control targets and supervised insulin administration.
  • Incipient or established senile dementia emerged as a significant factor in metabolic instability for three patients.
  • Unstable diabetic control preceded mental deterioration in one case, highlighting a crucial diagnostic link.

Implications:

  • Recognizing dementia as a contributing factor to brittle diabetes in the elderly is crucial for effective management.
  • Tailored therapeutic approaches are necessary for elderly patients with brittle diabetes.
  • Early identification of cognitive decline may be facilitated by monitoring diabetic control in older adults.

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