7th Indo Global Diabetes Summit and Medicare Expo
Title: Challenges in Care of Elderly Diabetics
Biography: Shilpa Paranjape
We are facing challenge of increasing elderly population with diabetes and prediabetes.
The problems that are specific to elderly diabetics include : (i) Non responsive bacterial and fungal infections, (ii) Hypoglycemia, (iii) Frequent falls, fatigue, dizziness, (iv) Increased Incontinence and bladder dysfunction, (v) Electrolyte imbalance and Nutritional deficiencies, (vi) Hyperosmolar Non-Ketotic Coma, (vii) Frozen Shoulder, (viii) Cardiovascular events,(ix) Renal decompensation, (x) Hepatic Dysfunction, (xi) Depression, Anxiety, (xii) Neurological complications,etc to name a few. All these factors exert serious impact on quality of life of the patient as well as aggravated healthcare burden and cost.
The goal of treatment differs in elderly. A delicate balance between Hypoglycemia and Hyperglycemia has to be maintained. Medical Nutrition therapy and Exercise therapy have to be Individualised keeping in view the functional and physical capacity of the person as well as their socio-economic status. Home monitoring of Blood Glucose and Blood Pressure should be advocated as frequent hospital visits may not be possible for elderly people. Optimal use of modern technology for communication should be utilised for monitoring the patient. Drug therapy should be designed considering the co morbidities, side effects of drugs and drug-drug interaction between various drugs. Drugs with multiple effects and combination therapies can be advocated to reduce the pill burden.
Thus, though care of elderly diabetic is a challenging task, it can be efficiently handled with team effort of qualified physician, diabetes educator, nutritionist, supportive family member, attendant and patient. Individualisation of therapy is key to good management of an elderly diabetic.