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Case Study 3
A veteran aged eighty, living alone, diagnosed with diabetes mellitus type 2 (T2D) twelve years ago, displaying normal renal functioning, and prescribed insulin injections besides other oral anti-hyperglycemic drug (OAD), reported hypoglycemia attacks. Their potential consequences (unconsciousness or even, in extreme cases, death) frightened him. His attendant has been negligent in holiday and weekend periods, resulting in irregular insulin administration, which subsequently resulted in hypoglycemia episodes. As a result, the patient was prescribed insulin degludec; with time, this medication’s dosage was increased and he began displaying better fasting blood sugar and HbA1c levels, without hypoglycemia attacks. Case results indicate a combination of diet changes and degludec gave required diabetes control whilst ensuring no hypoglycemia episodes occurred.
Population
Over one-quarter of America’s 65+-aged population cluster is diabetes-diagnosed, with the general population’s aging being a key diabetes-endemic driving factor. Elderly diabetics depict considerable risks for chronic as well as acute cardiovascular and microvascular diabetes-related complications. In spite of being the age-group displaying greatest diabetes incidence, researchers typically neglect elderly individuals and individuals depicting multiple comorbidities when conducting therapeutic randomized control trials (RCTs) and diabetes and related ailments’ therapy target RCTs. Latest surveillance information reveals...
Aged diabetics exhibit highest visual impairment, myocardial infarction, end-stage kidney disease, and severe lower-extremity (L-E) amputation among all age-groups (Jain & Paranjape, 2013).
Intervention
Aged diabetics’ disease management ought to consider their heterogeneity, unique desires and requirements (especially quality-of-life related goals), and pertinent goals right from the start. Elderly diabetics ought to be diagnosed via an in-depth geriatric evaluation. Physical and cognitive dysfunction and other geriatric ailments are commonly seen among aged diabetics, besides conventional vascular complications. Thus, in-depth geriatric evaluation ought to cover screening tests for geriatric, cardiovascular and microvascular complications. In case of inadequate or intolerable drug therapy, insulin ought to be prescribed for attaining proper glycemic control. Novel long-acting analogs of insulin are appropriate for aged patients, on account of their easy use and decreased hypoglycemia risks. Elderly patients and caregivers ought to be provided adequate education regarding hypoglycemia signs, hypoglycemia treatment, and blood sugar testing prior to insulin therapy commencement (Abdelhafiz & Sinclair, 2013).…
References
Abdelhafiz, A. H., & Sinclair, A. J. (2013). Management of Type 2 Diabetes in Older People. Diabetes Therapy, 4(1), 13–26. http://doi.org/10.1007/s13300-013-0020-4
Jain, A., & Paranjape, S. (2013). Prevalence of type 2 diabetes mellitus in elderly in a primary care facility: An ideal facility. Indian Journal of Endocrinology and Metabolism, 17(Suppl1), S318–S322. http://doi.org/10.4103/2230-8210.119647
Moghissi, E. (2013). Management of Type 2 Diabetes Mellitus in Older Patients: Current and Emerging Treatment Options. Diabetes Therapy, 4(2), 239–256. http://doi.org/10.1007/s13300-013-0039-6
Swinnen, S. G., Hoekstra, J. B., & DeVries, J. H. (2009). Insulin Therapy for Type 2 Diabetes. Diabetes Care, 32(Suppl 2), S253–S259. http://doi.org/10.2337/dc09-S318
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