Optimum insulin use in older diabetics

Insulin treatment of the elderly diabetic patient differs little from that advocated for the younger adult population, although in general the standards for blood glucose control are raised in the elderly by 10 mg/dl per decade, starting at age 60. These higher standards are recommended primarily to minimize the risk of hypoglycemia. Within these limits, control of diabetes will retain the older patient's vigor, alertness, and health. Insulin therapy can also be flexible to suit the requirements of individual patients. For those with residual endogenous insulin secretory capacity, a single dose of modified insulin may suffice. For those with greater insulin needs, split-dose schedules supplemented with regular insulin can be instituted, depending on the severity of the deficiency. Most important, the program for the aging diabetic should be simple and practical, and family members or community health personnel can be enlisted to assist in diabetic care and monitoring.