Diabetes in older people

The number of people over the age of 65 with diabetes, principally type 2 diabetes, is growing. Increasing insulin resistance and reduced insulin secretion make age a major predisposing factor for type 2 diabetes.¹

Patients are frequently asymptomatic, so macrovascular and microvascular damage may well be present by the time the diagnosis is made. Managing risk factors and established complications in the elderly should take account of co-morbidities, lifestyle and social setting, cognitive function and life expectancy, with a view to maximising autonomy and quality of life.²

Pharmacological treatment goals must be realistic and safe, acknowledging the metabolic consequences of age, the risks of hypoglycaemia and the dangers of polypharmacy.³ A holistic appraisal is essential and an individualised approach required.