[Diabetes in the elderly patient].
BACKGROUND
Diabetes mellitus in the elderly population is a major public health challenge. The aging population (over 65 years) now makes up 26.83% of the overall population in France and the prevalence of diabetes mellitus in this population is an estimated 10.3 to 20%.


METHODS
The pathophysiology of diabetes is complex and mainly involves age-related insulin resistance. Changes in body fat, nutrition, and hormone secretions (insulin growth factor, dehydroepiandrosterone) also play an important role. Chronic hyperglycemia alone is pathogenic.


RESULTS
Most are severe and induce not only dramatic vascular complications, diabetic foot, retinopathy, and neuropathy, but also, in association with age-induced illnesses and frail homeostasis, produce a high rate of disablement and decay of quality of life.


RESULTS
Current management of diabetes in the elderly population can be greatly improved. Systematic follow-up is essential, with special care to preserve self-independence. Education and self-monitoring play an important role. Large diet allowances are recommended. Available drug therapies for the elderly (basically insulin, short half-life sulfamides, metformine if renal function in normal, and exceptionally alpha-glucosidase inhibitors) must be examined in light of the specific situation of this frail population and the age-related changes in metabolism. Blood glucose control can be improved without risking unacceptable levels of hypoglycemia.
Alix
M
M
Centre pour Personnes Agées, CHU de Caen, 53, boulevard de la Charité, F 14000 Caen.
D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D005602:France / Q000453:epidemiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000145:classification / Q000494:pharmacology / Q000627:therapeutic use; D007333:Insulin Resistance / Q000502:physiology; D010353:Patient Education as Topic; D018579:Patient Selection; D015995:Prevalence; D011634:Public Health
D001786:Blood Glucose; D007004:Hypoglycemic Agents
Diabète chez le sujet âgé.