Specificities of type 2 diabetes in the elderly

Specificities of type 2 diabetes in the elderly The prevalence of type 2 diabetes (DT2) increases significantly with the age. Recent data show that 50% of patients with type 2 diabetes are over 65 years old, and 25% are over 75 years old. Aging is not the same in different people or in different patients. Aging may be classified in three types: successful aging, pathological aging and physical dependency. Frailty is an intermediate state. The elderly diabetic is at high risk because of the cardiovascular and functional complications (neuropathy, visual deficit), vascular risk factors (hypertension, dyslipidemia) and mental disorders (cognitive disorders, dementia, depression, and brain damage). It is important to detect the clinical signs of frailty in elderly diabetics because gerontological intervention has been shown to be effective in preventing loss of autonomy and in improving the quality of life. Treatment is difficult because it has to take into account the risk/benefit ratio. The side effects of drugs, especially hypoglycaemia, may be dangerous in the elderly. Patient education remains essential and must be specific. Dietary advice, physical activity and medical treatment must be personalized and are important for blood sugar control, nutritional balance and the chances of a successful aging.