February 27, 2013 by  
Filed under Health Blog

Elevated or low blood glucose can affect people of any age but here’s the latest research in the effects of glucose imbalances in our elderly:


Lynnette Hoffmann
Medical Observer

Both hyperglycaemia and hypoglycaemia may adversely affect cognitive function.

Despite an abundance of political dialogue around both our ageing population and rapidly rising rates of diabetes, current clinical guidelines that combine the two are decidedly lacking.

Spurred by the omission of key age-related issues in most diabetes guidelines, such as frailty, changing mental health, limited function and increasing dependency, three international diabetes groups recently held a series of focus groups and round table discussions on how diabetes management could be improved in older people.

In July, a collaborative position statement was published in JAMDA. Deakin University professor Trisha Dunning was one of the co-authors.

The groups took the round-table approach because randomised controlled trial evidence for best practice in this population is scant as older people are often excluded from studies, Professor Dunning says.
“The position statement tries to highlight the very specific needs of older people, that one-size-fits-all guidelines may not suit them. “Often symptoms and presentations are different in older people, and they’re more likely to have liver and kidney disease or have other comorbidities, ” she explains.

Australian guidelines developed in 2003 can still be found online, but they are out of date and don’t address special needs of people who are no longer independent.

That said, Professor Dunning and her colleagues at Deakin are in the process of evaluating new guidelines for managing people with diabetes who are living in residential care.

She believes one of the biggest challenges will be changing “ageist attitudes”, combating the idea that it doesn’t matter much if an elderly person’s blood glucose levels are above the recommended targets, for example.

Professor Dunning asserts that both hyperglycaemia and hypoglycaemia may adversely affect cognitive function.

Patients can also present with atypical symptoms such as lethargy instead of thirst when they have hyperglycaemia or nausea, and “feeling a bit off” when they have hypoglycaemia, instead of the textbook symptoms of sweating, trembling, hunger or palpitations.

Serious complications, such as infections, heart attacks or loss of consciousness, can be prevented with adequate monitoring.

“Risk assessments should also be a regular thing,” Professor Dunning says.

Patients on glucose-lowering medications should be screened for risk of falls and other safety issues such as driving.

The bottom line, she says, is to take patients’ concerns seriously, even if they are vague or atypical.

Professor Dunning concludes that it’s important to be attuned to subtle changes in symptomatology over time, such as increasing lassitude.
JAMDA 2012;13:497-502

For professional health care advice on how to balance glucose levels naturally and help prevent disease, consult a qualified Naturopathic Physician.

Yours In Great Health,

Sar Rooney BHSc., ND., DC., DASc., GDSc. (Hons), MATMS, MNHAA, MHATO
Naturopathic Medicine Practitioner, Lecturer, Researcher

Earth Medicine TM
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