Management Of Inpatient Hyperglycemia And Diabetes In Older Adults

Management of Inpatient Hyperglycemia and Diabetes in Older Adults

Adults aged 65 years and older are the fastest growing segment of the U.S. population, and their number is expected to double to 89 million between 2010 and 2050. The prevalence of diabetes in hospitalized adults aged 65–75 years and over 80 years of age has been estimated to be 20% and 40%, respectively. Similar to general populations, the presence of hyperglycemia and diabetes in elderly patients is associated with increased risk of hospital complications, longer length of stay, and increased mortality compared with subjects with normoglycemia. Clinical guidelines recommend target blood glucose between 140 and 180 mg/dL (7.8 and 10 mmol/L) for most patients in the intensive care unit (ICU). A similar blood glucose target is recommended for patients in non-ICU settings; however, glycemic targets should be individualized in older adults on the basis of a patient’s clinical status, risk of hypoglycemia, and presence of diabetes complications. Insulin is the preferred agent to manage hyperglycemia and diabetes in the hospital. Continuous insulin infusion in the ICU and rational use of basal-bolus or basal plus supplement regimens in non-ICU settings are effective in achieving glycemic goals. Noninsulin regimens with the use of dipeptidyl peptidase 4 inhibitors alone or in combination with basal insulin have been shown to be safe and effective and may represent an alternative to basal-bolus regimens in elderly patients. Smooth transition of care to the outpatient setting is facilitated by providing oral and written instructions regarding timing and dosing of insulin as wel Continue reading

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What’s the Best Diet for Diabetes? An Expert Weighs In

Diabetes is quickly becoming a world health issue, with the prevalence of the condition among adults rising from 4.7 percent in 1980 to 8.5 percent in 2014. In the U.S. the numbers are even more staggering—1 in 11 Americans has diabetes, and nearly half of kids and adults are at risk. One of the best ways you can help reduce your risk or manage your symptoms is through healthy eating, and in the Diabetes (Type 1) and Diabetes (Type 2) groups in the Fitbit app, community members are sharing support and encouragement. One of the biggest questions they’re currently discussing: “what’s the best diet for diabetes?” “Healthy eating for diabetes is healthy eating for everybody,” says Sacha Uelmen, Director of Nutrition for the American Diabetes Association. “But we never recommend one specific plan, because the best diet for you is so personal, from your family to your finances.”
The usual healthy eating advice still applies. (Hint: Eat more veggies! Avoid processed foods!) But with diabetes, there is more to keep in mind. The immediate priority is to manage your blood glucose levels, and if you have type 2 diabetes, your doctor may recommend you set a long-term goal to lose weight. To do both, you have to understand carbs and calories, and start timing your meals and snacks evenly throughout the day. Here are a three different approaches.
The Plate Method
“Start with your plate,” says Uelmen. “That’s a super easy visual, and the first and best thing everyone can do is eat more veggies.” The method involves filling half of your plate with non-starchy ve Continue reading

Do Statins Raise Odds for Type 2 Diabetes?

TUESDAY, Oct. 24, 2017 (HealthDay News) -- Cholesterol-lowering medications known as statins may lower your risk of heart disease, but also might boost the odds you'll develop type 2 diabetes, new research suggests.
"In a group of people at high risk of type 2 diabetes, statins do seem to increase the risk of developing diabetes by about 30 percent," said the study's lead author, Dr. Jill Crandall. She's a professor of medicine and director of the diabetes clinical trials unit at Albert Einstein College of Medicine in New York City.
But, she added, that doesn't mean anyone should give up on statins.
"The benefits of statins in terms of cardiovascular risk are so strong and so well established that our recommendation isn't that people should stop taking statins, but people should be monitored for the development of diabetes while on a statin," she explained.
At least one other diabetes expert agreed that statins are still beneficial for those at risk of heart trouble.
Dr. Daniel Donovan Jr. is professor of medicine and director of clinical research at the Icahn School of Medicine at Mount Sinai Diabetes, Obesity and Metabolism Institute in New York City.
"We still need to give statins when LDL (bad) cholesterol isn't under control. A statin intervention can lower the risk of a cardiovascular event by 40 percent, and it's possible the diabetes may have been destined to happen," he said.
The new study is an analysis of data collected from another ongoing study. More than 3,200 adults were recruited from 27 diabetes centers across the United States for the study.
The research g Continue reading

Will Type 2 Diabetes Affect My Memory?

Diabetes does cause memory loss. It may not be a progressive process that is clinical Alzheimer’s disease or dementia, but it can happen related to the acute symptoms of diabetes. Interestingly, Alzheimer’s disease has been called “Type 3 Diabetes” or “Alzheimer ’s disease of the Brain” lately.
In this article, we will look at how your diabetes affects memory and when and why this happens. To do this, we need to understand the four different types of memory loss. Also, looking at the symptoms and causes of memory loss will be helpful as we seek to learn how our Type 2 Diabetes may affect our memory.
To further break it down, we will look at the two types of memory loss that results from Type 2 Diabetes, short and long-term memory loss.
Types of memory loss or amnesia
There are four different types of memory loss. The two that are most common, and that you may have heard of, are short-term memory loss and long-term memory loss.
The other two types of memory loss, sensory memory loss and working memory loss, may not be as well-known. However, they are important to the preservation of human memory, thought and cognitive processes. As with many parts of the human body, memory loss is a complex issue. It involves many different factors, of which Type 2 Diabetes is one.
Short-term memory loss
The first sign of cognitive decline and one of the first symptoms of memory loss is short-term memory loss. I see this with my mother, when she doesn’t remember my dog’s name, or anything about the story that I just told her related to when I got him, how old he is, and all Continue reading

13 Ways to Prevent Diabetes

A bout 25% of Americans are at risk for type 2 diabetes – though most of us have no idea. A poor diet, not exercising enough, even aging raises our likelihood. Fortunately, simple efforts to improve our health can make a big difference. Read on for 13 diabetes prevention tips...
How serious a health problem is type 2 diabetes, the most common form of this incurable disease?
Very. More than 29 million people in the U.S. have it, and by 2034, that number will jump to 44 million, according to a University of Chicago (UC) study.
In addition to affecting our health and families, type 2 diabetes will strain the U.S. health system, costing $336 billion per year by 2034, UC researchers predict.
Why the increase? Blame the rise in obesity.
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