Although much attention has been focused on the new generation of kids being diagnosed with diabetes, diabetes is no stranger to the elderly population. Of the more than 16 million Americans with diabetes, more than half are older than 60. And almost 20 percent of people over age 65 have the disease. The numbers are even worse in ethnic groups that have increased risk of the disease: Almost one-third of older Latinas, Latinos and African-Americans have it, as do three-quarters of older Pima Indians.

Diabetes is a disease that sometimes must be managed in different ways as the patient ages. Pancreatic beta cells function less efficiently in old age, which causes a decrease in insulin production. Less lean tissue and more fat mean an increase in insulin resistance. Complicating factors are the presence of other conditions common in the elderly such as high blood pressure, whose symptoms may be worsened by the diabetes.

Can older diabetics be successfully treated? Yes, even though there are challenges. Every diabetic knows that lifestyle changes are key to keeping the disease under control, and making these changes may be difficult the older the patient gets. Losing weight, getting adequate exercise, quitting smoking, and eating a more healthful diet can pose obstacles for the elderly patient, as can remembering to take his or her medication. Budget constraints may affect which medicines the patient takes. Doctors recognize the need to look at each case individually and make recommendations based on the patient's health status, life expectancy, independence and support system.

Despite the fact that diabetes becomes increasingly common with age, getting it is not inevitable. One study at Yale University revealed that older people may develop insulin resistance, one of diabetes' major risk factors, due to a decline in activity in their mitochondria, the "power centers" that fuel the body's cells. Yet in a follow-up study, the researchers discovered that physical activity can boost the number of mitochondria in the muscles, giving credence to the theory that exercise can help ward off diabetes. A study conducted by the Diabetes Prevention Program at the National Institute on Aging showed that older adults at high risk of developing diabetes could delay its onset by eating a low-calorie, low-fat diet and getting regular moderate exercise.

The good news is that clinical trials are being designed to include more older diabetes patients, which hopefully will provide as much information as possible on the management of the disease well into the golden years. 


Source: Howard Hughes Medical Institute, Yale University, www.hhmi,org, National Diabetes Information Clearinghouse,