Abstract: This chapter covers the major metabolic disturbances affecting the elderly diabetic person. It considers the special characteristics in the elderly: their precipitating factors and their management. The majority of these problems can be avoided and all ill elderly people need their plasma glucose measured whether or not diabetes has been diagnosed. The three hyperglycaemic problems occurring in the elderly are diabetic keto-acidosis, hyper-osmolar non-ketotic coma and normo-osmolar, non-ketotic, hyponatremic hyperglycaemia associated with impaired renal function. Risk factors and management for each are described. Elderly people often have poor hypoglycaemic awareness and the key is recognition of the condition. Lactic acidosis can be due to biguanide therapy and other metabolic disorders or to shock and tissue hypoxia caused by severe organ failure: the former is discussed. Elderly patients with diabetes are at great risk from several other acute conditions, such as myocardial infarction, difficulties with eating and poor glycaemic control. Intercurrent illness also affects people with diabetes: patients and/or carers should be familiar with the 'sick day rules'.
Publication Year: 2000
Publication Date: 2000-12-20
Language: en
Type: other
Indexed In: ['crossref']
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