Endocrinology Features

The older patient with diabetes is more prone to having hypoglycaemia. Yet the IDF estimates that over half the population of people with diabetes do not know that they have it.

Older people with type 2 diabetes who are functionally independent should be managed following NICE guidelines.

Depression is common in older people with diabetes that tends to be underdiagnosed, acting as a risk factor and at the same time as a consequence.

The complexity of issues surrounding a patient over the age of 50 with diabetes, especially the very elderly and frail, require a healthcare professional to have a sound understanding of different scenarios encountered.

The comprehensive diagnosis of diabetes in older patients is not always straightforward. Having diagnosed diabetes, it is important to ascertain the type.

This article looks at management of diabetes during Ramadan when fasting can put patients at an increased risk of hypoglycaemia, hyperglycaemia and dehydration.

Introduction
Definitions
Incidence and risk factors
Counter regulatory responses
Consequences of hypoglycaemia
Goals of treatment
Conclusion
References

Type 1 diabetes occurs when pancreatic beta cells are subject to an autoimmune attack of unknown origin. Developing a cure, or making type 1 diabetes easier to manage for the millions of people affected by it worldwide, would have a huge positive impact on people’s lives.

Diabetes is common amongst patients with mental health problems, particularly schizophrenia. This may be due to shared genetic factors, but lifestyle issues, such as smoking and poor diet in patients with schizophrenia, put them at particular risk for metabolic problems.

A high prevalence of diabetes exists in older patients and the clinical priorities of managing diabetes in old age are often different compared with other groups.