Article Review on Diabetes

Article Review on Diabetes

Type 2 diabetes affects many older adults, and it may be more complicated by other chronic conditions. Today, different treatment options are appropriate for the management of Type 2 diabetes for older people depending on life expectancy, functional status, and comorbid conditions. It is recommendable that the care of older people diagnosed with diabetes should be individualized and person-centered to ensure the best results. The purpose of this paper is to review an article by April Bigelow and Barbara Freeland on ‘Type 2 Diabetes Care in the Elderly’.

The article identifies that age is a factor contributing to Type 2 diabetes. In every four adults over the age of 65 Years, one has been diagnosed with Type 2 Diabetes, while another 50% are prediabetes that puts them at a higher risk of getting diabetes soon (Bigelow & Freeland, 2017). Giving care to diabetic patients can be overwhelming to both the caregivers and patients, especially the elderly patients who suffer from other chronic conditions.  The article’s primary purpose is to identify particular considerations for the care of elderly diabetic patients.

The article indicates that recently during diagnosis and screening, the symptoms of diabetes are subtle. Traditionally polydipsia, polyuria, and polyphagia were considered to be symptoms of Type 2 Diabetes in adults (Bigelow & Freeland, 2017). Today however, the symptoms may be less pronounced in the elderly because of the increment in the renal threshold and impaired thirst mechanism for glucose with age. The caregivers misinterpret different symptoms that are associated with diabetes as symptoms of other conditions. For example, neuropathy and poor healing of wounds are also signs and symptoms of peripheral vascular disease. Regularly screening should be done since the age of 45 to diagnose diabetes in older people. In older people, hemoglobin A_1c is the best assessment option for diagnosis.

Self-monitoring and glucose control is one of the ways of managing diabetes among older people. Hemoglobin A_1c  should be measured more often to help in controlling glucose levels. The recommended target of hemoglobin A_1c is between 7.5 and 8%. Self-monitoring of glucose in the blood is recommendable for all patients with diabetes (Bigelow & Freeland, 2017). Assessing the ability to understand the implications of the outcomes and perform the procedure is necessary before making the recommendations. Monitoring should be individualized at home based on cognition, management type, comorbidities, and dexterity.

Management of obesity, reduction of weight, and change in lifestyle are therapy for Type 2 diabetes patients. Exercising, eating healthy, and checking on weight are recommended for the elderly since they are the root of the treatment of Type 2 diabetes. Besides the management of obesity and change in lifestyle, pharmacological therapy is considered necessary for the treatment of diabetes (Bigelow & Freeland, 2017). Metformin is the most preferred agent for oral therapy in older patients since it has lower risks of hypoglycemia. Generally, drugs with few side effects such as dipeptidyl peptidase-4 inhibitors are safe for users.

Patients should also be aware of the complications such as hypoglycemia and understand the immediate options of treatment available. Screening and evaluation should also be done often to identify complications. Financial support, community resources, and the support systems of the patient should be discussed with the patient during doctor visits to ensure the quality of life (Bigelow & Freeland, 2017).

Polypharmacy is considered risky for older people with diabetes, mainly because they have some chronic illnesses. There are risks of interaction with other diseases and side effects associated with polypharmacy. The article indicates that the caregivers maintain a medication list that is right containing medications that are taken by the patient. Drugs should be reviewed annually to allow for the elimination of unnecessary medicines and evaluate interactions.

Patients should also be aware of the complications such as hypoglycemia and understand the immediate options of treatment available (Bigelow & Freeland, 2017). Screening and evaluation should also be done often to identify complications. Financial support, community resources, and the support systems of the patient should be discussed with the patient during doctor visits to ensure good life quality.