/p>In those over 70 years of age, the percentage of prevalence of diabetes exceeds 15% and it is estimated that, at present, the half of the elderly who suffer from it are unaware of their diseaseas warned by the Spanish Society of Geriatrics and Gerontology (SEGG). And it is that from the age of 70 diabetes triggers silently and is not diagnosed.
It is precisely in older people where Diabetes presents atypical manifestations that make their diagnosis difficult. For this reason, on the occasion of World Health Day, which is celebrated on April 7 dedicated this year to diabetes, from the it is clarified that the comprehensive geriatric assessment It is essential to avoid that the disease can go unnoticed.
As stated by the Dr. José Antonio López Trigopresident of the SEGG, “Diabetes is a disease that increases with age and 40 percent of those diagnosed with diabetes are over 65 years of age.” and it is expected that those affected by this ailment increase greatly in the coming years due to the proliferation of some unhealthy lifestyle habits such as a sedentary lifestyle or pathologies such as obesity.
The diabetes is a serious disease It occurs when blood glucose levels are very high and can cause high-risk health problems (hypoglycemia, cardiovascular problems, eye diseases, kidney damage, etc.) that worsen in older people.
Despite the increasing prevalence of diabetes, high blood glucose levels can be controlled to help counteract the disease and prevent or delay future problems. But from the SEGG it is warned that this control does not happen in all cases, since “currently half of diabetic elderly people are unaware that they areso they are not treating their disease, and this increases the risk of functional deterioration ”, as explained by Dr. López Trigo. “Many of these undiagnosed elderly are suffering from health problems that they attribute to age. This may be due to diseases that are not well treated, including diabetes, which also presents the added problem of being, on many occasions, silent in its manifestations”, clarifies the president of the SEGG.
On the other hand, at functional impairment suffered by older people with diabetes adds a certain degree of cognitive decline due to neurotoxicity caused by hyperglycemia, hypoglycemia, insulin or glycosylated products, which further complicates the problem.
The elderly patient has some particular characteristics that make their disease control worse, since functional and cognitive deterioration substantially worsen their quality of life and this has a direct and negative impact on the evolution of diabetes.
Some elderly patients with cognitive impairment may not fully understand the basics of treatment and may not know what to do in the event of a complication, for example, hypoglycemia. To this we must add that they have a greater risk of medication errors (for example, they can administer an excess of insulin).
Poor control of the disease can lead to the appearance of microvascular complications (retinopathy, neuropathy and nephropathy) and macrovascular (peripheral vascular circulation, arteriosclerosis in carotid or coronary deterioration).
In it older patient Other circumstances that can make diabetes management difficult can be worsening visual acuity, depression, social problems, or limited access to balanced meals.
In addition, the diabetic patients use twice as many resources both in-hospital and out-of-hospital than non-diabetic patients, and patients over 75 years of age have higher mortality rates than patients in the same group without diabetes.
For all this, from the the following are recommended performances Regarding the treatment, control and follow-up of the elderly diabetic patient:
- Continuous education of the family, caregivers and residential media personnel is necessary.
- Instructions to the elderly diabetic patient should be simple.
- The treatment of the elderly should be individualized. It must be taken into account if you suffer from cognitive impairment and sensory deficiencies.
- The practice of sport is recommended: preferably resistance exercises such as walking or cycling. Aerobic exercise is beneficial in delaying the onset of diabetes and in improving insulin resistance in those with established disease.
- Weight loss is advised, as even slight losses bring benefits.
- Reduction of cardiovascular risk factors, including smoking, is recommended.
- Hanging or home alarm systems can be very useful to control the elderly diabetic.
- It is necessary that older diabetics undergo an annual review. In frail or highly dependent elderly people, check-ups should be frequent to ensure that the treatments are appropriate and that they do not present adverse reactions.
- The diet must be controlled (above all it is necessary to reduce fats), like the rest of the drugs they take (polymedication).
- Weight gain, blood pressure, microalbuminuria (early sign of nephropathy), feet, and glucose should be monitored periodically.
- Urinary glucose tests are less reliable, since in this group of patients the renal glycemic threshold is altered.