Type 2 Diabetes: Geriatric Considerations

The dramatic increase in the incidence and prevalence of type 2 diabetes affects all age groups and has led to a notable increase in type 2 diabetes in children and young adults. Nonetheless, diabetes remains very much a disease of the elderly. The prevalence of known cases of diabetes increases from 6% for persons aged 45 to 64 years, to 15% for those aged 65 and older, with an additional 7% to 12% having undiagnosed diabetes (Fig. 1) (1,2). In addition, up to 30% of people over age 65 have impaired glucose regulation (IGR) [impaired glucose tolerance (IGT) or impaired fasting glucose (IFG)], a condition that increases the risk of diabetes as well as cardiovascular disease (3). In total, abnormal glucose regulation affects almost half of older adults and has substantial impact on public health and clinical care. Medical care for patients with diabetes is costly; approximately two-thirds of all medical costs related to diabetes are attributable to the elderly (4). As the U.S.