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Age Related Diabetes

Diabetes Mellitus And Risk Of Age-related Macular Degeneration: A Systematic Review And Meta-analysis

Diabetes Mellitus And Risk Of Age-related Macular Degeneration: A Systematic Review And Meta-analysis

Abstract Age-related macular degeneration (AMD) is a major cause of severe vision loss in elderly people. Diabetes mellitus is a common endocrine disorder with serious consequences, and diabetic retinopathy (DR) is the main ophthalmic complication. DR and AMD are different diseases and we seek to explore the relationship between diabetes and AMD. MEDLINE, EMBASE, and the Cochrane Library were searched for potentially eligible studies. Studies based on longitudinal cohort, cross-sectional, and case-control associations, reporting evaluation data of diabetes as an independent factor for AMD were included. Reports of relative risks (RRs), hazard ratios (HRs), odds ratio (ORs), or evaluation data of diabetes as an independent factor for AMD were included. Review Manager and STATA were used for the meta-analysis. Twenty four articles involving 27 study populations were included for meta-analysis. In 7 cohort studies, diabetes was shown to be a risk factor for AMD (OR, 1.05; 95% CI, 1.00–1.14). Results of 9 cross-sectional studies revealed consistent association of diabetes with AMD (OR, 1.21; 95% CI, 1.00–1.45), especially for late AMD (OR, 1.48; 95% CI, 1.44–1.51). Similar association was also detected for AMD (OR, 1.29; 95% CI, 1.13–1.49) and late AMD (OR, 1.16; 95% CI, 1.11–1.21) in 11 case-control studies. The pooled ORs for risk of neovascular AMD (nAMD) were 1.10 (95% CI, 0.96–1.26), 1.48 (95% CI, 1.44–1.51), and 1.15 (95% CI, 1.11–1.21) from cohort, cross-sectional and case-control studies, respectively. No obvious divergence existed among different ethnic groups. Therefore, we find diabetes a risk factor for AMD, stronger for late AMD than earlier stages. However, most of the included studies only adjusted for age and sex; we thus cannot rule out conf Continue reading >>

Diabetes In Seniors

Diabetes In Seniors

What is diabetes? Diabetes (also called diabetes mellitus) is a chronic (ongoing) condition characterised by high blood glucose (blood sugar) levels due to the body’s inability to produce or respond to insulin, a hormone that allows blood glucose to enter the cells of the body and be used for energy. Why are seniors at risk of diabetes? Of course, seniors (those over 65) are not the only people to be affected by diabetes: type 1 diabetes (previously known as insulin-dependent diabetes or juvenile-onset diabetes) is usually diagnosed during childhood, while type 2 diabetes (previously known as non-insulin dependent diabetes or adult-onset diabetes), the most common type, is usually diagnosed in adults over the age of 45, although a growing number of young people are developing type 2 diabetes. Gestational diabetes is a type of diabetes that occurs only during pregnancy. Type 2 diabetes is linked to an unhealthy lifestyle. Major risk factors for diabetes include age, being overweight, genetic predisposition to diabetes, and a reduction in activity levels. The rates of type 2 diabetes steadily increase with age. Type 2 diabetes is most likely to occur if you: are over 45 years old and have high blood pressure; are over 45 years old and are overweight; are over 45 and have (or have had) one or more family members with diabetes; are over 55 years of age; have had a heart attack in the past; have heart disease; have or have had a blood sugar test that is borderline-high; have or have had high blood sugar levels during pregnancy (a condition called gestational diabetes); have polycystic ovary syndrome and are overweight; are an Aboriginal Australian or Torres Strait Islander and are over 35 years old (or younger if overweight); or are a Pacific Islander, are from a Chinese c Continue reading >>

Type 2 Diabetes

Type 2 Diabetes

Overview Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. The hormone insulin – produced by the pancreas – is responsible for controlling the amount of glucose in the blood There are two main types of diabetes: type 1 – where the pancreas doesn't produce any insulin type 2 – where the pancreas doesn't produce enough insulin or the body's cells don't react to insulin These pages are about type 2 diabetes. Read more about type 1 diabetes. Another type of diabetes, known as gestational diabetes, occurs in some pregnant women and tends to disappear after birth. Symptoms of diabetes The symptoms of diabetes occur because the lack of insulin means glucose stays in the blood and isn't used as fuel for energy. Your body tries to reduce blood glucose levels by getting rid of the excess glucose in your urine. Typical symptoms include: feeling very thirsty passing urine more often than usual, particularly at night feeling very tired weight loss and loss of muscle bulk See your GP if you think you may have diabetes. It's very important for it to be diagnosed as soon as possible as it will get progressively worse if left untreated. Causes of type 2 diabetes Type 2 diabetes occurs when the body doesn't produce enough insulin to function properly, or the body's cells don't react to insulin. This means glucose stays in the blood and isn't used as fuel for energy. Type 2 diabetes is often associated with obesity and tends to be diagnosed in older people. It's far more common than type 1 diabetes. Treating type 2 diabetes As type 2 diabetes usually gets worse, you may eventually need medication – usually tablets – to keep your blood glucose at normal levels. Complications of type 2 diabetes Diabetes can cause serious long-term heal Continue reading >>

Healthy Aging With Diabetes

Healthy Aging With Diabetes

“I can tell you one thing — growing old ain’t for wimps!” —gray-haired gentleman at Sterling Center YMCA in Beverly, Massachusetts It used to be said that having diabetes aged people an additional 20 years. Today, thanks to better tools for managing diabetes and preventing and treating its complications, people with diabetes have the opportunity to live longer than ever before. However, managing diabetes in the golden years presents a variety of challenges, ranging from increased insulin resistance to being on multiple drugs. Here is what you should know about the effects of diabetes on aging and vice versa, and what you can do to stay healthy and full of vitality well into old age. What happens during aging As you age, you may be most aware of your new gray hairs and wrinkles, but aging causes changes throughout the entire body. A person’s basal metabolic rate — the amount of energy the body expends at rest — declines with age. By some estimates, a person’s basal metabolism drops by 2% per decade starting at age 20. Some researchers believe that this decline is due almost solely to the loss of muscle mass that comes with age. The body’s ability to process oxygen — its aerobic capacity — also declines with age. By some estimates, a person’s aerobic capacity by age 65 is typically only 60% to 70% of what it was when he was younger (although the decline appears to be less in older people who exercise regularly). This decline may be due to several factors, including poor lung function, heart function, and blood circulation. With advancing years, the body gradually becomes less adept at taking up and using glucose from the bloodstream — a condition known as glucose intolerance, which sets the stage for Type 2 diabetes. One contributing factor to Continue reading >>

Considering Why Type 2 Diabetes Is An Age-related Condition

Considering Why Type 2 Diabetes Is An Age-related Condition

Permalink | Read 2 Comments | Add a Comment | Share | Posted by Reason Type 2 diabetes is the poster child for an avoidable age-related condition : barring the worst of genetic bad luck, calorie restricted , well exercised people will not suffer from type 2 diabetes. But this is, undeniably, an age-related illness. Becoming ever more obese and sedentary will hasten the onset of diabetes into ever earlier years of life, but older obese and sedentary people are still far more likely to suffer type 2 diabetes than are equally overweight and sedentary younger counterparts. So while failing to take care of your health at any age is just another form of self-harm, there are other, less avoidable processes taking place at the level of cells and organs that make older people more vulnerable. Here is an open access paper that reviews what researchers presently know of the decline of insulin-producing beta cells in the pancreas - which turns out to be not enough, as is still true of so much of our biochemistry. There are changes, cataloged and identified, but the chains of causation for those changes are poorly understood at best. Type 2 Diabetes and the Aging Pancreatic Beta Cell An increased incidence of diabetes is observed with age, and there are many possibly reasons for this. One of these is that the beta cell has reduced proliferative capacity and in diabetic individuals this is further confounded by higher rates of beta cell apoptosis . The currently known underlying mechanisms behind the reduction in beta cell proliferation observed with age include reduced expression of cell cycle activators, increased expression of cell cycle inhibitors, reduced pdx1 expression , and increased amylin aggregation. Studying aging in the non-diabetic rodent and human models is currently Continue reading >>

Elder Diabetes Patients — Know The Signs And Symptoms Of Type 2 Diabetes In This Population To Improve Care

Elder Diabetes Patients — Know The Signs And Symptoms Of Type 2 Diabetes In This Population To Improve Care

By Jill Weisenberger, MS, RD, CDE Today’s Dietitian Vol. 15 No. 3 P. 20 Jean, 78, has been experiencing urinary incontinence and showing signs of confusion. Her physician also notices she’s slightly dehydrated. When he suggests screening Jean for type 2 diabetes, she thinks this is a waste of time. After all, she isn’t experiencing frequent urination or excessive thirst, which she knows are telltale symptoms of the disease. But the truth is Jean’s symptoms are typical in elder patients newly diagnosed with type 2 diabetes. Elder patients often present with different signs and symptoms of diabetes, so it’s important for RDs to know what these are so they can help this patient population stabilize blood glucose levels with proper nutrition or refer them to a physician who specializes in geriatric diabetes care. Different Signs and Symptoms More than one-quarter of the US population aged 65 and older has diabetes,1 including type 1 and 2, and approximately one-half of older adults have prediabetes. In this population, age-related insulin resistance and impaired pancreatic islet function increase the risk of developing the disease. Because of these age-related physiological changes, elder patients may not present with classic symptoms of hyperglycemia. The renal threshold for glucose increases with age, and older people often have impaired thirst mechanisms. Thus, polyuria and polydipsia may be absent. Common presenting symptoms are dehydration, dry eyes, dry mouth, confusion, incontinence, and diabetes complications, such as neuropathy or nephropathy.2 Hypertension and dyslipidemia frequently coexist with diabetes, but in elder diabetes patients so do dementia, depression, and functional decline.3 In general, individuals with type 2 diabetes have twice the risk o Continue reading >>

Older People And Diabetes

Older People And Diabetes

Save for later Most areas of care in diabetes are relevant to all age groups but there are some specific changes due to growing older which might affect your diabetes. Food choices In some cases dietary advice for the older person with diabetes may differ from general recommendations. Older people in care homes are often more likely to be underweight than overweight and there is a high rate of undernutrition. It may not always be appropriate to reduce the fat, salt and sugar for every older person with diabetes. Poor or irregular eating can often be a cause of hypos. Poor oral health, effects of some drugs on the digestive system, limited mobility, dexterity or vision can all cause discomfort associated with eating. Fluid intake is often lower in older people which can cause dehydration, particularly during bouts of illness. People at risk should have a nutritional assessment and individual advice from a dietitian to address areas of concern such as needing extra calories, meal supplements and replacements, weight reduction, low salt diet or manageable foods. Nutritional assessment and diet should form part of your individual care plan if you live in a care home. Personal food preferences are important in any diet plan and older people with diabetes should be able to continue to enjoy a wide variety of foods. Staff, including catering staff in older people's care homes, should have training to give them an understanding of the specific needs of individuals with diabetes. Keeping active Keeping active in later life helps to strengthen muscles, maintain mobility and balance and improves insulin sensitivity. It can help you to continue to self-care, can improve your mental well-being and prevent falls. You can aim to be as active as you are able. Older people, including th Continue reading >>

Diabetes: What You Need To Know As You Age

Diabetes: What You Need To Know As You Age

Overview Diabetes is a problem that has many consequences: If you have the disease, your body can no longer keep its blood sugar at a healthy level. But over time, the effects of diabetes can become much more complicated. The disease can lead to serious, even life-threatening problems from your head to your toes. Too much blood sugar (also called glucose) can damage the blood vessels and nerves that run throughout your body. This can set the stage for many other medical conditions: stroke heart disease kidney disease vision problems and blindness damage to the feet or legs However, there is good news for the 26 million Americans with diabetes—and those at risk. Experts are learning more all the time about lifestyle steps for diabetes control and prevention. New medications and devices can also help you keep control over your blood sugar and prevent complications, says Johns Hopkins expert Rita Kalyani, M.D. Definitions A1C Test: A blood test used to diagnose and monitor diabetes. By measuring how much glucose (also called blood sugar) is attached to the oxygen-carrying protein in your red blood cells, this test gives you and your health-care provider a picture of your average blood glucose levels over three months. A normal result is below 5.7 percent. If you have type 2 diabetes, you should have this test done twice a year to check if your blood glucose is under control. Blood glucose: Also referred to as blood sugar, the primary energy source for the cells in your body. Blood glucose levels rise after meals and fall the longer you’ve gone without eating. Your blood glucose level is a measure of how much glucose you have in your bloodstream. A normal fasting blood glucose level is between 70 and 100 mg/dl (milligrams per deciliter of blood). Insulin (in-suh-lin): A Continue reading >>

Differential Effects Of Metformin On Age Related Comorbidities In Older Men With Type 2 Diabetes

Differential Effects Of Metformin On Age Related Comorbidities In Older Men With Type 2 Diabetes

Volume 31, Issue 4 , April 2017, Pages 679-686 Differential effects of metformin on age related comorbidities in older men with type 2 diabetes Author links open overlay panel Chen-PinWangab To identify distinct temporal likelihoods of age-related comorbidity (ARC) diagnoses: cardiovascular diseases (CVD), cancer, depression, dementia, and frailty-related diseases (FRD) in older men with type 2 diabetes (T2D) but ARC nave initially, and assess the heterogeneous effects of metformin on ARCs and mortality. We identified a clinical cohort of male veterans in the United States who were 65years old with T2D and free from ARCs during 20022003. ARC diagnoses during 20042012 were analyzed using latent class modeling adjusted for confounders. The cohort consisted of 41,204 T2D men with age 74.65.8years, HbA1c 6.50.97%, and 8393 (20.4%) metformin users. Four ARC classes were identified. Healthy Class (53.6%): metformin reduced likelihoods of all ARCs (from 0.14% in dementia to 6.1% in CVD). High Cancer Risk Class (11.6%): metformin reduced likelihoods of CVD (13.3%), cancer (45.5%), depression (5.0%), and FRD (13.7%). High CVD Risk Class (17.4%): metformin reduced likelihoods of CVD (48.6%), cancer (3.2%), depression (2.8%), and FRD (6.3%). High Frailty Risk Class' (17.2%): metformin reduced likelihoods of CVD (18.8%), cancer (3.9%), dementia (3.8%), depression (15.6%), and FRD (23.8%). Metformin slowed ARC development in old men with T2D, and these effects varied by ARC phenotype. Continue reading >>

Age Of Onset For Type 2 Diabetes: Know Your Risk

Age Of Onset For Type 2 Diabetes: Know Your Risk

According to the Centers for Disease Control and Prevention (CDC), 21 million people were diagnosed with diabetes in 2012. The CDC also notes that 90 to 95 percent of cases in adults involve type 2 diabetes. In the past, type 2 diabetes was most prevalent in older adults. But due to widespread poor lifestyle habits, it’s more common in younger people than ever before. Type 2 diabetes is often preventable. Learn what you can do to prevent or delay its onset, no matter your age. Middle-aged and older adults are still at the highest risk for developing type 2 diabetes. According to the CDC, there were a total of 1.7 million new total diabetes cases in 2012. In 2012, adults aged 45 to 64 were the most diagnosed age group for diabetes. New cases of both type 1 and type 2 diabetes in people aged 20 years and older were distributed as follows: ages 20 to 44: 371,000 new cases ages 45 to 64: 892,000 new cases age 65 and older: 400,000 new cases People aged 45 to 64 were also developing diabetes at a faster rate, edging out adults aged 65 and older. Type 2 diabetes used to be only prevalent in adults. It was once called “adult-onset” diabetes. Now, because it is becoming more common in children, it’s simply called “type 2" diabetes. While type 1 diabetes, which is believed to be due to an autoimmune reaction, is more common in children and young adults, type 2 diabetes is rising in incidence, attributed in part to poor lifestyle habits. According to the American Diabetes Association, about 5,090 people under the age of 20 are diagnosed with type 2 diabetes every year. A 2012 study published in Diabetes Care considered the potential future number of diabetes cases in people under the age of 20. The study found that, at current rates, the number of people under the age o Continue reading >>

Feature/diabetes Care For Older Adults

Feature/diabetes Care For Older Adults

Diabetes Spectrum Volume 12 Number 2, 1999, Pages 70 – 77 These pages are best viewed with Netscape version 3.0 or higher or Internet Explorer version 3.0 or higher. When viewed with other browsers, some characters or attributes may not be rendered correctly. Feature/Diabetes Care for Older Adults Mooradian and Associates Diabetes Care for Older Adults Arshag D. Mooradian, MD, Sue McLaughlin, RD, CDE, Cecilia Casey Boyer, RN, MSN, CDE, and Jewel Winter, BSN, GNP Abstract Diabetes is a common problem in older adults. Approximately 20% of individuals over 65 years of age have diabetes mellitus, and almost half of these individuals have not been diagnosed. However, there are widespread misconceptions about possible consequences of uncontrolled hyperglycemia, the rate at which diabetic complications develop, and the role of multidisciplinary management. Overall, management strategies for diabetes in older adults are no different from those of diabetes in younger groups, with some exceptions. Unlike younger people with type 2 diabetes, who are often overweight, obesity is not that common among older diabetes patients. In nursing homes, the problem of being underweight is as common as that of being overweight. Thus, nutritional management should focus on weight gain for underweight elderly patients as much as it is focused on weight loss for obese patients. In addition to diet and exercise, pharmacological therapy is often required for optimizing blood glucose control. Target blood glucose ranges should be individualized. In frail patients, fasting plasma glucose levels should range from 100 to 140 mg/dl, and postprandial values should be <200 mg/dl. Older subjects may require extra educational support to become proficient in self-monitoring of blood glucose. The discovery Continue reading >>

Diabetes And The Elderly

Diabetes And The Elderly

Tweet Both average life expectancy and the prevalence of diabetes are continuing to rise. Amongst the elderly population, type 2 diabetes is a growing problem, and a larger proportion of newly diagnosed diabetics are older. Treating and diagnosing diabetes amongst the elderly requires a flexible and unique approach. What are the differences in diagnosing diabetes amongst the elderly when compared to diabetes amongst the young? There are numerous physiological changes underway as our bodies grow and adapt to their age. Elderly people who are at risk of developing diabetes, or who have already developed the disease, may not exhibit the classic symptoms expected. Age-related changes can mean that some symptoms will be masked, or harder to spot. What are the differences in treatment of diabetes amongst the elderly when compared to diabetes amongst the young? Treating diabetes amongst the elderly can present unique challenges. Other disabilities associated with aging can contribute to the complexity of strictly self-managing diabetes. Impaired physical functioning amongst some elderly patients can mean that adjusting to a diabetes care routine is more difficult. Cognitive impairment can also provide an obstacle. Are there increased risks when an elderly person develops diabetes? Elderly people are often more frail and susceptible to illness. This can mean diabetes-related complications are more common and harder to manage. Furthermore, exercise and adapting a diet can be more difficult for elderly people, and problems can arise in these areas. All diabetes complications can occur amongst older patients. Cognitive complications are more common amongst the elderly. Further problems may include undiagnosed depression, social issues, limited daily means and coexisting health pro Continue reading >>

Diabetes In Older Adults

Diabetes In Older Adults

What is the epidemiology and pathogenesis of diabetes in older adults? According to the most recent surveillance data, the prevalence of diabetes among U.S. adults aged ≥65 years varies from 22 to 33%, Continue reading >>

Age-related Cataract Is Associated With Type 2 Diabetes And Statin Use

Age-related Cataract Is Associated With Type 2 Diabetes And Statin Use

Several studies have identified diabetes as a risk factor for age-related (AR) cataracts. 1 6 It has been predicted that by the year 2025, >300 million people in the world will have diabetes, 7 and a corresponding global increase in AR cataract can be expected. Studies have shown that taking statins (HMG-CoA reductase inhibitors) reduces cardiovascular risks in patients with diabetes, even in those without high LDL-cholesterol. 8 , 9 Consequently, statins are a class of pharmaceuticals commonly prescribed for patients with diabetes. Little work has been done specifically on the wide use of statins in patients with diabetes and their combined impact on cataract development. 10 Early clinical trials on patients without diabetes did not find significant lenticular changes with statin use of <5 years. 11 14 Subsequently, no adverse side effects on the human lens were listed in current drug compendiums, and manufacturers did not recommend monitoring of the crystalline lens. Furthermore, statin use was generally not controlled for in studies on diabetes and its associations to AR cataract. However, animal studies have clearly shown a correlation between cataract development and chronic statin treatment, although drug dosages have been generally higher than the clinical levels given to humans. 15 17 A few human population studies have suggested a protective effect of statin use on cataract risk, 18 20 hypothesizing an anti-inflammatory/antioxidant mechanism for the effect. 20 Recently, Hippilsley-Cox and Coupland 21 looked at data for >2 million patients (ages 3084) in a prospective cohort study involving 368 general practices in the United Kingdom. The effects of statin type, dose, and duration of use were estimated by Cox proportional hazard models. Refuting earlier finding Continue reading >>

Diabetes In Older People

Diabetes In Older People

On this page: Diabetes is a serious disease. People get diabetes when their blood glucose level, sometimes called blood sugar, is too high. The good news is that there are things you can do to take control of diabetes and prevent its problems. And, if you are worried about getting diabetes, there are things you can do to lower your risk. What Is Diabetes? Our bodies turn the food we eat into glucose. Insulin helps glucose get into our cells, where it can be used to make energy. If you have diabetes, your body may not make enough insulin, may not use insulin in the right way, or both. That can cause too much glucose in the blood. Your family doctor may refer you to a doctor who specializes in taking care of people with diabetes, called an endocrinologist. Types of Diabetes There are two main kinds of diabetes. Type 1 diabetes. In type 1 diabetes, the body makes little or no insulin. Although adults can develop this type of diabetes, it occurs most often in children and young adults. Type 2 diabetes. In type 2 diabetes, the body makes insulin but doesn’t use it the right way. It is the most common kind of diabetes. It occurs most often in middle-aged and older adults, but it can also affect children. Your chance of getting type 2 diabetes is higher if you are overweight, inactive, or have a family history of diabetes. Diabetes can affect many parts of your body. It’s important to keep diabetes under control. Over time, it can cause serious health problems like heart disease, stroke, kidney disease, blindness, nerve damage, and circulation problems that may lead to amputation. People with type 2 diabetes also have a greater risk for Alzheimer’s disease. What Is Prediabetes? Many people have “prediabetes.” This means their glucose levels are higher than normal but Continue reading >>

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