Clinical Management of Diabetes Mellitus in the Older Adult Patient.

BACKGROUND: In 2009, approximately 40 million people were 65 years or older. The majority of people over the age of 65 have at least one chronic medical condition. In 2002-2003, the following medical conditions were common among older adults: hypertension (51%), arthritis (48%), heart disease (31%), cancer of any type (21%), and diabetes (16%). The cost of diabetes care, both direct and indirect, was $245 billion in 2012. Fifty-nine percent of the direct medical cost was for the population aged 65 and over. METHODS: A literature review was conducted with a review of mostly peer-reviewed publications from 1987 - 2016 in the preparation of this manuscript. RESULTS: Management goals include control and minimization of hypo- and hyperglycemia and their symptoms, evaluation and treatment of associated risks for atherosclerotic and micro-vascular disease; evaluation and treatment of related complications; support for diabetes self-management and education; maintenance or improvement of the patient's general health status. CONCLUSION: Providers, patients, caregivers and family members should be vigilant to recognize and manage, micro - and macro-vascular diseases quickly, to prevent increased incidence in morbidity and mortality, as well as medical costs of diabetes care attributed to this age group.

Psychosocial factors in aging.

Many psychosocial factors have been associated with successful aging. The impact of social relationships, personality factors, self-perceptions,and religiosity/spirituality is reviewed in this article and recommendations for enhancing psychological aging are provided.