Acute and late onset complications of diabetes – do they pose a significant problem in the elderly?

Authors: P. Weber ;  H. Meluzínová ;  D. Prudius ;  K. Bielaková
Published in: Geriatrie a Gerontologie 2016, 5, č. 4: 196-201
Category: Review Article


Diabetes mellitus (DM) represents a major risk factor for acute and late onset diabetic complications. DM can be seen, to some extent, as a model of aging. In old age it is often a part of polymorbidity and contributes to the mosaic of coexisting diseases. Therapy itself with the use of insulin or insulin secretagogues (oral antidiabetic drugs – sulphonylurea, etc.) may, for seniors, entail a particularly significant risk of hypoglycaemia, which may lead to the development of other acute vascular complications (stroke, heart attack, arrhythmia, etc.). The authors outline other acute and chronic late onset complications especially from the perspective of large senior population heterogeneity.

diabetes – old age – acute and late complications – management


1. Hunter JA, Haslett C, Chilver AR, Boon NA, Colledge A (eds.). Principles & Practice of Medicine (Davidson’s). 22nd Edition. Edinburgh, UK. Churchill Livingstone 2014.

2. Wiener Ch, Fauci A, Braunwald E, Kasper D (eds.). Harrison’s Principles of Internal Medicine 18th Edition, New York, USA. McGraw-Hill Professional Publishing Division 2012.

3. Kvapil M (ed.). Diabetologie. Praha: Triton 2012.

4. Haluzík M a kol. Praktická léčba diabetu. 2. vyd. Praha: Mladá fronta 2013.

5. Kirkman MS, Briscoe VJ, Clark N, et al. Diabetes in older adults. Diabetes Care 2012; 35(12): 2650–2664.

6. Chiniwala N, Jabbour S. Management of diabetes mellitus in the elderly. Curr Opin Endocrinol Diabetes Obes 2011; 18(2): 148–152.

7. American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care 2013; 36(Suppl.1): S11–S66.

8. Laubscher T, Regier L, Bareham J. Diabetes in the frail elderly: individualization of glycemic management. Can Fam Physician 2012; 58(5): 543–546.

9. Munshi MN, Maguchi M, Segal AR. Treatment of type 2 diabetes in the elderly. Curr Diab Rep 2012; 12(3): 239–245.

10. Yau CK, Eng C, Cenzer IS, et al. Glycosylated hemoglobin and functional decline in community-dwelling nursinghome-eligible elderly adults with diabetes mellitus. J Am Geriatr Soc 2012; 60(7): 1215–1221.

11. Inzucchi SE, Bergenstal RM, Buse JB. Management of hyperglycemia in type 2 diabetes: a patient-centered approach – position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2012; 35(6): 1364–1379.

12. Bramlage P, Gitt AK, Binz C, et al. Oral antidiabetic treatment in type-2 diabetes in the elderly: balancing the need for glucose control and the risk of hypoglycemia. Cardiovasc Diabetol 2012; 6(10): 111–122.

13. Greenway FL. Severe hypoglycemia in the Look AHEAD Trial. J Diabetes Complications 2016; 30(5): 935–943.

14. Sako A, Yasunaga H, Matsui H, et al. Hospitalization for hypoglycemia in Japanese diabetic patients: A retrospective study using a national inpatient database, 2008–2012. Medicine (Baltimore) 2015; 94(25): e1029.

15. Sanchai T, Patumanond J. Severe hypoglycemia in type II diabetes at Nakornping General Hospital: a study on clinical risk factors. J Med Assoc Thai 2011; 94(12): 1435–1440.

16. Eriksson M, Carlberg B, Eliasson M. The disparity in long-term survival after a first stroke in patients with and without diabetes persists: the Northern Sweden MONICA study. Cerebrovasc Dis 2012; 34(2): 153–60.

17. Basanta-Alario ML, Ferri J, Civera M, et al. Differences in clinical and biological characteristics and prevalence of chronic complications related to aging in patients with type 2 diabetes. Endocrinol Nutr 2016; 63(2): 79–86.

18. Tóth G, Szabó D, Sándor GL, et al. Diabetes and diabetic retinopathy in people aged 50 years and older in Hungary. Br J Ophthalmol 2016; pii: bjophthalmol-2016-309016. (Epub ahead of print).

19. Bailey CJ, Day C. Diabetes therapies in renal impairment. Br J Diabetes Vasc Dis 2012; 12(4): 167–171.

20. Williamson JD, Supiano MA, Applegate WB, et al; SPRINT research group. Intensive vs standard blood pressure control and cardiovascular disease outcomes in adults aged ≥75 years. JAMA 2016; 315(24): 2673–2682.

21. Paneni F, Beckman JA, Creager MA. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: part I. Eur Heart J 2013; 34(31): 2436–2443.

22. Sinclair AJ, Paolisso G, Castro M, et al. European diabetes working party for older people 2011 clinical guidelines for type 2 diabetes mellitus. Executive summary. Diabetes Metab 2011; 37(Suppl. 3): S27–S38.

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