Diabetes and the Elderly

Geriatric Diabetes Clinic

Older adults with diabetes face unique challenges in managing their disease. Other medical conditions and social issues can be barriers to their ability to control diabetes while enjoying a good quality of life.

The Geriatric Diabetes Clinic uses a multidisciplinary team approach to care for diabetes and the elderly. Our clinicians work together with our patients and take into consideration their medical, social and physical environment issues.

Special Concerns for Older Patients

An older person may have co-existing medical conditions, physical challenges, cognitive impairments or social barriers that can interfere with diabetes management. These concerns can include:

• Limited mobility
• Depression
• Memory impairment
• Lack of access to exercise
• Inability to prepare appropriate meals.

Additionally, a frail, older person has increased risk for falls. Because episodes of low blood glucose (hypoglycemia) can lead to falls, frequent adjustment of diabetes treatment goals may be necessary.

What the Geriatric Team Does

The Geriatric Diabetes Clinic team works to:

• Identify barriers unique to each older person with diabetes that impair the patient’s ability to self-manage the disease.
• Set appropriate goals for treatment of diabetes after consideration of the person as a whole.
• Educate and help older individuals and their caregivers in diabetes management and safety issues.

The clinic’s physician conducts the initial evaluation. An appointment is then made with members of the multidisciplinary team for further assessment. This includes screening for the presence of memory disorder, depression, physical disabilities and the patient’s current knowledge about diabetes. Dietary habits are evaluated, as is the patient’s ability to follow nutritional recommendations. The patient’s social support structure is also assessed for potential referral to a social worker.

After assessment, the Geriatric Diabetes Team develops goals and treatment plans during its weekly meetings. Both patients and referring physicians are notified of the results and follow-up recommendations, via a comprehensive letter from the team. The final goal is individualized treatment of older adults with diabetes, with an emphasis on safety issues.