Diabetes in the elderly

Diabetic phenotypes in the elderly are extremely diverse. The many different manifestations of hyperglycemia in this population in part result from a dichotomy of patients. Some patients present at an earlier age and progress through their life with diabetes. This group exhibits higher burden of complications which contribute to geriatric syndromes, thus demonstrating how the complications of diabetes promote accelerated aging. Other patients develop diabetes at a later age and can thus be viewed as examples of aging itself being a risk factor for loss of glycemic control. The management of diabetes in the elderly, as with younger patients, involves lifestyle changes, education, andmonitoring, as well as multiple classes of medications. The goals of therapy in the elderly need to be individualized based on many factors. The prime directive of "do no harm" in the elderly is vital, particularly in regard to avoidance of hypoglycemia.