The management of diabetes in the elderly has unique challenges. With increasing age, there is an increased prevalence of comorbid illnesses and functional disability that contributes to the complexity of managing diabetes in the elderly cohort. Thus, treatment must take into consideration not only the standard micro- and macrovascular complications associated with both aging and diabetes, but also conditions such as cognitive impairment and impaired function. Importantly, elderly patients with diabetes have an increased risk for cardiovascular disease.⁵

The diagnosis of diabetes in the elderly also presents challenges, and it is estimated that half of the elderly population with diabetes are not diagnosed correctly with the condition. This is due to many factors, including the observation that this cohort rarely presents with the typical symptoms of hyperglycemia,^6,7 the renal threshold for glucose increases naturally with age, making it difficult to identify glucosuria, and fsting blood glucose measurements or oral glucose tests are not routinely performed in this population. Additionally, common symptoms such as fatigue, blurred vision, and polyuria are often not recognized as abnormal in this population, and polydipsia can go unnoticed because of the decreased thirst usually associated with advanced age.


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