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Diabetes is a serious health condition in the aging population. According to the American Diabetes Association (ADA) “approximately twenty-five percent of people over the age of 65 have Diabetes and that number is expected to increase significantly in the coming decades.”

Care of these individuals present unique challenges, special considerations and economic burden. The reasons are multiple and include:
 Higher risks Diabetes complications
 Higher rates co-morbidities
 Greater risks common geriatric syndromes
 Increased difficulty with self-management
 Normal aging process

Normal aging changes impacts Diabetes influencing care and management. The primary focus of care is preventing hypoglycemia, hyperglycemia and cognitive decline. Overtreatment common, intensive glycemic control not shown to be beneficial. The ADA recommends setting glycemic goals based upon health status, functional dependence and cognitive impairment.

Hypoglycemia is the single greatest threat and reason for hospitalization in this age group. Initial symptoms in older adults primarily neurological. May not be recognized increasing falls risk, hospitalization, hypoglycemia unawareness. PREVENTION, recognition, prompt treatment, education and organizational policies lower these risks.

Aging effects, physical inactivity, weight gain is some of the factors contributing to hyperglycemia in older adults. Both fasting and post meal blood sugars increase with age. Older adults rarely present with typical symptoms. Post meal hyperglycemia primary symptom, contributing to under diagnosed Diabetes in this population. Important to check 2-hour post meal blood sugars to lower risks complications, especially when sick or after surgery.

Diabetes self-management education and support, involving caregiver and staff training play a significant role in helping older adults living with Diabetes achieve individualized treatment goals, reduce risks acute and chronic complications, emergency room visits and hospitalizations improving longevity and quality of life.

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