Improved Glycemic Control Reduces Risk of Diabetes-Related Complications

Daniel Tessier, MD, MSc, FRCPC, CSPQ
Sherbrooke Geriatric University Institute
Associate Professor, Faculty of Medicine
University of Sherbrooke

Introduction
The most recent Health and Nutrition survey in the United States demonstrated that the prevalence of diabetes is approaching 20% in Caucasian patients over the age of 70, and in certain ethnic groups, may be as high as 50%.1 Currently, the over 65 age group represents about 13 % of the total population, a percentage which is expected, by the year 2020, to increase to approximately 21% of the population. The majority of elderly diabetic patients have type 2 diabetes mellitus (DM), characterized by a gradually increasing glycemia that results from a combination of a resistance, at the cellular level, to the action of insulin, and a gradual decline of insulin secretion by the pancreas. A few years of asymptomatic disease may have elapsed prior to the diagnosis of DM being made, especially in the case of elderly patients. The following article will provide a brief review of the acute complications related to DM in the elderly with a particular focus on the evolution of the disease, side effects of treatment, and the vascular problems and acute infections that are often associated with this health problem.