Diabetes in the elderly.
The purpose of treating diabetes in the elderly is to avoid very high blood sugars and a hyperosmolar, non-ketotic state which means severe dehydration and delirium. The build-up of acid from high sugars (ketoacidosis) is very uncommon in the elderly.
In my experience, diabetes is generally over-treated in the frail elderly.
In frail older patients, particularly those with multiple co-morbidities or other disease processes and dementia, we should be very conservative with blood glucose control to avoid hypoglycaemia- low blood glucose.
Older people and their families think that diabetic elderly literally have to starve and drastically reduce kilojoules just because they have diabetes. I still see many malnourished elderly diabetics!
Malnutrition is equally important in diabetic elderly as it is in non-diabetic elderly.
Diabetics who are malnourished need to eat more of the right food including extra protein, low GI foods rather than eating less.
For more information read Dr Peter Lipski’s book “Your Elderly Parents Failing Health. Is It Ageing Or A Treatable Condition”.