How should pharmacological treatment of diabetes in the elderly be regulated?
Pharmacological treatment should be regulated according to the person’s abilities and comorbodities. Elderly patients should be treated with the principle of “start low and go slow”. Oral antidiabetic drugs and insulin are used in the treatment of diabetes in the elderly.
Could testosterone therapy benefit men with Type 2 diabetes?
Could testosterone therapy benefit men with type 2 diabetes? Men with type 2 diabetes and low testosterone levels can benefit significantly from testosterone treatment, according to a study published in Diabetes Care. With testosterone treatment, fat turned to muscle in men with diabetes.
Can type 2 diabetes be cured after age 50?
Type 2 diabetes doesn’t have a cure, but you can manage it with medications and healthy lifestyle choices as you age. Here are a few steps to take to enjoy a healthy life with type 2 diabetes after age 50: Take your medications as directed by your doctor.
What is the management of type 2 diabetes?
Management of type 2 diabetes includes: 1 Healthy eating 2 Regular exercise 3 Weight loss 4 Possibly, diabetes medication or insulin therapy 5 Blood sugar monitoring
What is the first line drug for patients with type 2 diabetes and obesity?
Metformin is indicated as the first line agent for obese patients with diabetes, and although metformin is considered to have weight neutral effects, some studies have shown weight loss of up to 2–3 kg [24,25].
Which is the most appropriate treatment for type 2 diabetes?
Metformin (Fortamet, Glumetza, others) is generally the first medication prescribed for type 2 diabetes. It works primarily by lowering glucose production in the liver and improving your body's sensitivity to insulin so that your body uses insulin more effectively.
What is the preferred and most common initial drug to treat type 2 diabetes while using monotherapy?
In general, the use of metformin as the first treatment for oral hypoglycemic monotherapy is recommended because of its excellent blood glucose-lowering effect, relatively low side effects, long-term proven safety, low risk of hypoglycemia, and low weight gain.
What drug treatment would be prescribed for a patient with type 2 diabetes?
Metformin. Metformin is the most common medicine for type 2 diabetes. It can help keep your blood sugar at a healthy level.
What are the two main treatments for type 2 diabetes?
There's no cure for type 2 diabetes, but losing weight, eating well and exercising can help you manage the disease. If diet and exercise aren't enough to manage your blood sugar, you may also need diabetes medications or insulin therapy.
What is better than metformin for type 2 diabetes?
Insulin remains the most effective therapy to lower glucose, particularly in comparison to most oral medicines for type 2 (including metformin).
Which of the following medications are indicated to improve glycemic control in adult patients with diabetes mellitus?
Sulfonylureas. Sulfonylureas (eg, glyburide, glipizide, glimepiride) are insulin secretagogues that stimulate insulin release from pancreatic beta cells and probably have the greatest efficacy for glycemic lowering of any of the oral agents.
Which metformin is best for diabetes?
Obimet. Obimet is often the first choice of metformin brands for people with diabetes and obesity. Obimet lowers hypoglycaemia risks and comes in blister packs of ten tablets, usually either 500mg or 1000mg. Obimet is sometimes prescribed as an initial therapy, or may be delivered alongside a sulphonylurea.
What is glycemic control for adults with diabetes?
The American Diabetes Association recommends an HbA1c level of below 7% as a target for optimal blood glucose control and further recommended adequate glycemic control with pre-prandial capillary plasma glucose 80–130 mg/dl [25].
Which is safer metformin or glimepiride?
CONCLUSIONS—Glimepiride reduced A1C similarly to metformin with greater weight gain, and there was comparable safety over 24 weeks in the treatment of pediatric subjects with type 2 diabetes.
Why is metformin a good choice as first-line treatment?
Metformin is a biguanide that is used as first-line treatment of type 2 diabetes mellitus and is effective as monotherapy and in combination with other glucose-lowering medications. It is generally well-tolerated with minimal side effects and is affordable.
When should a Type 2 diabetic take insulin?
Insulin should be initiated when A1C is ≥7.0% after 2–3 months of dual oral therapy. The preferred regimen for insulin initiation in type 2 diabetes is once-daily basal insulin.
What are the goals of diabetes treatment in elderly patients?
The goals of diabetes treatment in elderly patients include hyperglycemia and risk factors, as in younger patients. comorbid diseases and functional limitations of individuals should be taken into consideration when setting treatment targets. Thus, treatment should be individualized.
Why are older people at higher risk for diabetes?
Older adults are at higher risk for developing type 2 diabetes because of the combined effects of increased insulin resistance and pancreatic islet dysfunction. Economic burden.
What is sarcopenia type 2?
Sarcopenia is characterised by a progressive decline in skeletal muscle mass and that is the reason for low muscle strength and impaired physical performance[2]. Elderly (adults over age 65 years) individuals with type 2 DM have a great risk for sarcopenia and physical disability[3].
What is DM in health?
Core tip:Diabetes mellitus (DM) is one of the most common lifelong chronic diseases in the world and its ratio is increasing by aging population. Elderly patients with type 2 DM have an increased risk for coronary heart disease, stroke and vascular diseases.
How much money is spent on diabetes?
Again according to United States data, about $245 million is spent yearly on diabetes patients, of which $176 million is direct medical costs, while $69 million is the loss of production and mortality[12]. In addition, 59% portion of the annual treatment costs have been made for the elderly diabetic individuals.
What are the complications of diabetes mellitus?
In addition to macrovascular and microvascular complications of elderly patients of diabetes mellitus, geriatric syndromes such as cognitive impairment, depression, urinary incontinence, falling and polypharmacy are also accompanied by aging.
Does diabetes increase with age?
Glucose intolerance increases progressively by aging and the characteristic feature of diabetes in elderly patients is especially postprandial hyperglycemia. Decrease in beta-cell-compensating capacity with advancing age, leads to insulin resistance and it appears as a postprandial hyperglycaemia in the elderly[7].
Why is the number of older adults with diabetes increasing?
INTRODUCTION. The number of older adults with diabetes is rapidly increasing worldwide due to increased life span and a high prevalence of diabetes in the elderly. In many countries, the prevalence of diabetes is getting higher as a function of age. In Korea, one in every four adults aged 65 years and older had a diagnosis of diabetes in 2010 (Fig.
Why is insulin needed in older adults?
Due to the progressive decline of β-cell function with increasing age, insulin replacement therapy is frequently required in older adults with type 2 diabetes with long duration of disease. However, there are many barriers to appropriate insulin use in elderly with diabetes.
What are the comorbid conditions of diabetics?
Unlike young adults with diabetes, elderly diabetic people may be affected by a variety of comorbid conditions such as depression, cognitive impairment, muscle weakness (sarcopenia), falls and fractures, and physical frailty.
Is metformin a monotherapy?
aExpected reduction in HbA1c when used as a monotherapy. Metformin. Metformin is currently recommended as the first line drug therapy for the management of diabetes in many guidelines because of proven effectiveness in lowering blood glucose, a relatively low risk of hypoglycemia, and low cost [33].
Can you take glibenclamide with diabetes?
Glibenclamide (glyburide) should also be avoided in older adults with diabetes because of increased risk of hypoglycemia. In older adults, sulfonylureas should be started with the minimal dose and titrated gradually based on blood glucose monitoring.
Does diabetes affect skeletal muscle?
We have observed that older adults with type 2 diabetes have an altered body composition, low skeletal muscle strength, and poor muscle quality [10]. Furthermore, older adults with diabetes experience accelerated loss of lower extremity strength and muscle quality, as well as skeletal muscle mass [11,12].
Can metformin cause lactic acidosis?
These conditions may increase the risk of lactic acidosis, a very serious adverse event associated with metformin. Metformin should not be given to men with elevated serum creatinine ≥1.5 mg/dL, and women with serum creatinine ≥1.4 mg/dL, or those with estimated glomerular filtration rate (eGFR) of less than 30 mL/min.
How to get rid of diabetes?
Talk to your doctor if something is preventing you from taking your medications as directed. Get regular exercise. The American Diabetes Association recommends 30 minutes of moderate-to-vigorous intensity aerobic activity at least five days per week, and strength training at least twice per week.
What are the risks of type 2 diabetes?
Older adults with type 2 diabetes have a higher risk of cardiovascular disease, heart attack, and stroke compared to younger people with diabetes. Because of this, you should watch your blood pressure and cholesterol levels carefully. There are many ways to control your blood pressure and cholesterol. For example, exercise, diet changes, and ...
Why does blood sugar increase with age?
The risk for hypoglycemia increases with age. This is because as you get older, the kidneys don’t function as well at removing diabetes medications from the body.
What are the best doctors for diabetes?
Speak with your primary care doctor to find out if they recommend a referral to any of these specialists: 1 endocrinologist 2 pharmacist 3 certified diabetes educator 4 nurse educator or diabetes nurse practitioner 5 ophthalmologist or an optometrist (eye doctor) 6 podiatrist (foot doctor) 7 registered dietitian 8 mental health professional (therapist, psychologist, or psychiatrist) 9 dentist 10 exercise physiologist 11 cardiologist (heart doctor) 12 nephrologist (kidney doctor) 13 neurologist (a doctor specializing in disorders of the brain and nervous system)
How to live a healthy life with diabetes?
Here are a few steps to take to enjoy a healthy life with type 2 diabetes after age 50: Take your medications as directed by your doctor. One reason people don’t have good control over their type 2 ...
How to control high blood pressure?
There are many ways to control your blood pressure and cholesterol. For example, exercise, diet changes, and medications can help. If you have high blood pressure or cholesterol, discuss your treatment options with your doctor.
How to keep your feet clean as you get older?
As you get older, foot care becomes critical. You should keep your feet clean, dry, and protected from injury. Make sure to wear comfortable, well-fitting shoes with comfortable socks. Check your feet and toes thoroughly and contact your doctor right away if you notice any red patches, sores, or blisters.
What to do if you can't maintain your target blood sugar level?
If you can't maintain your target blood sugar level with diet and exercise, your doctor may prescribe diabetes medications that help lower insulin levels or insulin therapy. Drug treatments for type 2 diabetes include the following.
How long does it take to retest blood sugar?
If you have signs or symptoms of low blood sugar, drink or eat something that will quickly raise your blood sugar level — fruit juice, glucose tablets, hard candy or another source of sugar. Retest your blood in 15 minutes.
How does SGLT2 affect kidney function?
SGLT2 inhibitors affect the blood-filtering functions in your kidneys by inhibiting the return of glucose to the bloodstream. As a result, glucose is excreted in the urine. These drugs may reduce the risk of heart attack and stroke in people with a high risk of those conditions.
What is the normal blood sugar level for Type 2 diabetes?
This blood test indicates your average blood sugar level for the past two to three months. Results are interpreted as follows: Below 5.7% is normal. 5.7% to 6.4% is diagnosed as prediabetes.
What does a blood sugar level of 200 mean?
Regardless of when you last ate, a level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially if you also have signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test.
Do people with type 2 diabetes need insulin?
Some people who have type 2 diabetes need insulin therapy . In the past, insulin therapy was used as a last resort, but today it may be prescribed sooner if blood sugar targets aren't met with lifestyle changes and other medications.
Is weight loss surgery only for type 2 diabetes?
Your treatment will also include diet and nutritional supplement guidelines, exercise and mental health care. Generally, weight-loss surgery may be an option for adults living with type 2 diabetes who have a body mass index (BMI) of 35 or higher.
What is the most common type of diabetes in men?
Men and Type 2 Diabetes. Medically Reviewed by Michael Dansinger, MD on August 11, 2019. Type 2 diabetes, once called non-insulin dependent diabetes or adult-onset diabetes, is the most common form of diabetes, affecting 90% to 95% of the 13 million men with diabetes. The rates of diabetes have dramatically risen in all states.
How old do you have to be to get tested for diabetes?
The risk for type 2 diabetes usually goes up with age. People who don’t have other risk factors for the condition should start getting tested after age 45. Unlike people with type 1 diabetes, people with type 2 diabetes make insulin.
What test is used to diagnose type 2 diabetes?
Tests used to diagnose type 2 diabetes include a fasting plasma glucose test and a casual plasma glucose test. Complications of Type 2 Diabetes. If your type 2 diabetes isn't controlled well, you could get serious or life-threatening complications, including: Retinopathy.
What are the problems with diabetes?
Have metabolic syndrome (a cluster of problems that include high cholesterol, high triglycerides, low HDL or “good” cholesterol and high LDL or “bad” cholesterol, and high blood pressure) Don’t get up and around a lot. Eat a diet high in sugar and refined carbohydrates and low in fiber and whole grains.
Why is it important to control blood pressure and cholesterol?
It’s important to control not only sugars, but also blood pressure and cholesterol to stop eye diseases from getting worse. Fortunately, the vision loss isn't significant in most. Kidney damage. The risk of kidney disease rises over time, meaning the longer you have diabetes, the greater your risk.
Can you get Type 2 diabetes in a hospital?
Fatigue (weak, tired feeling) Blurred vision. Numbness or tingling of the hands or feet. Frequent infections of the skin or urinary tract. Rarely, a person may be diagnosed with type 2 diabetes after showing signs of it in a hospital while in a diabetic coma.
Is type 2 diabetes more common than type 1 diabetes?
Although it is more common than type 1 diabetes, type 2 diabetes is less well understood. It is probably caused by several things and not a single problem. Type 2 diabetes can run in families, but the exact nature of how it's inherited or the identity of a single reason for it in your genes is not known.
How long does a person live with type 2 diabetes?
A 2010 report from the United Kingdom estimated that type 2 diabetes reduced life expectancy by up to 10 years, while type 1 diabetes reduced it by at least 20 years, ...
What are the causes of death for people with diabetes?
Many health conditions can increase the effects of diabetes, such as kidney and heart disease, high blood pressure, and high cholesterol. Cardiovascular disease is the main cause of death among people with diabetes.
What are the risk factors for diabetes?
Common risk factors that can decrease life expectancy in people with diabetes include: being overweight or having obesity, particularly if it involves excess fat in the abdomen. having a diet that is low in fiber and high in sugar, fat, and salt. smoking. engaging in low levels of physical activity.
How does stress affect insulin?
Stress stimulates the release of hormones that can raise blood sugar and interfere with insulin regulation. Yoga, meditation, and speaking with a mental health professional or counselor can help combat stress.
Does diabetes affect life expectancy?
In addition, the longer a person has diabetes, the more likely it is to reduce life expectancy. Likewise, the younger a person is when they receive the diagnosis, the higher the risk that diabetes-linked complications will shorten their lifespan.
Does hand washing help with diabetes?
Regular hand- washing can reduce the risk of infections. People with diabetes have a higher risk of developing infections, such as influenza, pneumonia, and urinary tract infections. An infection that is relatively minor in a person without diabetes can become life-threatening in a person with the disease.
Does metformin help with blood sugar?
Also, medications such as metformin can help stabilize blood sugar levels, but only if a person takes them as the doctor prescribes.
What is the best way to control diabetes type 2?
Type 2 diabetes often require just a diet and lifestyle change, including exercise and weight loss. Other cases may require oral medications or insulin, and sometimes all of these in combination must be practiced to address the disease. Carbohydrate control is key to controlling both types of diabetes, as the body turns carbohydrates into glucose, ...
How to control blood sugar levels in diabetics?
Carbohydrate control is key to controlling both types of diabetes, as the body turns carbohydrates into glucose, making blood sugar levels rise . Eating a diet lower in carbohydrates featuring lean protein (beans, poultry, fish), and whole grain foods slow the release of sugar into the bloodstream. Lindsay cautions, however, ...
How many people have diabetes at 65?
The statistics are alarming: One in four people age 65 and older have either type 1 or type 2 diabetes, compared to one in 10 for those younger than 65, according to the American Diabetes Association. In addition, half of older adults have prediabetes, a condition that features higher-than-normal blood glucose levels.
Why do older people lose appetite?
Diet is key to controlling diabetes but, as an added challenge, older adults frequently suffer from a loss of appetite as their ability to taste and smell diminishes. In addition, their energy and activity levels drop, and depression may become a factor.
Can older adults have diabetes?
In addition, half of older adults have prediabetes, a condition that features higher-than-normal blood glucose levels. Prediabetes can lead to type 2 diabetes unless a lifestyle and diet change is adopted to slow the onset or prevent the disease entirely. Even more frightening—most people are unaware they have the disease ...
Can diabetes cause loss of appetite?
If unchecked, diabetes has a host of serious complications: Diet is key to controlling diabetes but, as an added challenge, older adults frequently suffer from a loss of appetite as their ability to taste and smell diminishes. In addition, their energy and activity levels drop, and depression may become a factor.
Can type 1 diabetes produce insulin?
A person with type 1 diabetes cannot produce insulin (also called insulin-dependent diabetes). “It’s very important for people with type 1 diabetes to coordinate the amount of carbohydrates they consume in conjunction with their insulin injections,” Lindsay says. With type 2 diabetes, the body produces insulin, but the cells resist taking it in (insulin-resistant). Type 2 diabetes often require just a diet and lifestyle change, including exercise and weight loss. Other cases may require oral medications or insulin, and sometimes all of these in combination must be practiced to address the disease.