diabetes

Question 1

diabetes in older adult

Answer 1

glucose takes longer to break down

hypo/hyperglycemia appear more well-tolerated in later life

insidious onset - organ damage might already have taken place prior to diagnosis

Question 2

early signs of alteration of BG levels in older adults

Answer 2

dehydration
delirium
confusion

change in functional abilities

*incontinence with hyperglycemia common

Question 3

diabetic screening

Answer 3

q3 years for those with HTN

Question 4

pharmacotherapy in older diabetes client

Answer 4

antiglycemic therapy

preventative cardiac adjuvant therapy (ACE inhibitors and ASA)

X sulfonylurea X: risk for hypoglycemia

Question 5

metformin

Answer 5

oral antidiabetic

watch renal function (X in CKD patients)

not indicated after 80yrs of age

Question 6

insulin

Answer 6

long acting - sliding scale inappropriate in older adults

Question 7

HgA1C considerations

Answer 7

results of 2-3 tests on two different days if possible

not reliable in some subpopulations - african, mediterranean, asian due to hemoglobin genetic variant

not always reliable in those with kidney failure or liver failure

Question 8

HgA1C

Answer 8

7.5% in healthy older adults

8-8.5% in medically fragile adults

emphasis on functional and health status rather than number results