Diabetes in U.S. nursing homes

Diabetes in Older Individuals

Diabetes continues to be a major source of concern for many individuals today, both young and old. Because of the hyperglycemia nature that follows from deficiencies in either insulin action or secretion for activity in the body. Nevertheless, in some situations, both factors contribute to diabetes. According to recent studies, there has been a considerable increase in the number of people diagnosed with diabetes, with the United States population alone seeing a 25% increase for those over the age of 65. Because diabetes is a chronic and costly disease, different therapies have been developed to treat the disease in both children and adults. However, for the purposes of this paper, the focus is on the specific intervention for the treatment of diabetes, specifically in the epidemiology and pathogenesis of diabetes in older individuals.

Epidemiology and Pathogenesis of Diabetes in Adults

Study of the epidemiology and pathogenesis of diabetes in adults is a critical aspect in the identification of high priority goals. Effective prevention, treatment, and cure of diabetes become a possibility from the vigorous research efforts of the various scientific aspects from the discovery research to the clinical trials and a later translation of the findings into effective clinical practice (Resnick, Heineman, Stone, & Shorr, 2004). Latest research studies conducted on diabetes have revealed that postprandial hyperglycemia stands out as the most prominent characteristic of type 2 diabetes in older adults. Such a determination, however, varies from one case to another depending on the diagnostic tool applied in the individual case. Such an example is in the use of A1C tool, a commonly applied test for national surveillances that reveals that almost a third of adults in the United States with diabetes are undiagnosed (Kirkman et al., 2012).

Link to Obesity and Overweight

Type 2 diabetes has a link to the increase in the rates of obesity and overweight, most especially among the US population. Such an approach is, however, expected to double in the next 20 years, despite the fact that the rates of diabetes could level off during the said period. Furthermore, new projections point to the fact that the cases of those diagnosed with diabetes and in their 65 years of age or more could equally be on the increase by an approximate of 4-5 fold, unlike the 3 fold that is the current projection since 2005 towards 2015. Despite the increase of individuals living with type 1 diabetes into their old ages, the discussion pertaining to pathophysiology mainly pertains to the type 2 diabetes, which is typically the most common and prevalent in adults of above 65 years. The study of epidemiology and pathogenesis of diabetes in adults involves two major aspects including the screening for diabetes and pre-diabetes as well as in prevention and delay of type 2 diabetes (Kirkman et al., 2012).

Screening and Prevention of Type 2 Diabetes in Older Adults

Based on the consideration that older adults stand a greater risk for both diabetes and pre-diabetes, screening is considered a critical practice from the latest research studies, with a recommendation that the practice focuses more on the overweight individual adults from the age of 45 onwards every 1-3 years (Resnick et al., 2004). Evidence has proved that early treatment of type 2 diabetes is of significant benefits, as it enormously reduces the chances of health deterioration. Moreover, type 2 diabetes is usually present in an individual for years before clinical diagnosis could clearly reveal its existence. Evidence has proved that complication signs are usually prevalent in the newly-diagnosed patients, thus making periodic screening an appropriate approach towards effective prevention of the condition. Besides monitoring, numerous clinical trials done have clearly proved that in individuals of high-risk subjects, especially those with the condition of impaired glucose intolerance, type 2 diabetes could easily be prevented or its acute nature delayed by the simple aspect of lifestyle intervention as well as the use of different medication classes (Kirkman et al., 2012). Some of such interventions include glycemic control, lipid lowering, and control of blood pressure among others. Such approaches have proved that delay and prevention of type 2 diabetes is indeed a possibility, most especially among the older adults who have proved to be the most vulnerable to such an aspect. From such a perspective, it is evident that epidemiology and pathogenesis of diabetes in older adults is indeed a critical intervention towards the reduction of the soaring cases of type 2 diabetes in adults.

Effective Control of Diabetes in Older Adults

Even though a number of interested parties have come up with various guidelines pertaining to adults with comorbidity, their failure to provide viable evidence leaves the gaps in the provision of appropriate guidance to clinicians for use. As such, from this particular study, it is clear that the research pertaining to the epidemiology and pathogenesis of diabetes in older adults provides viable evidence of the research objective proven. As such, with appropriate strategies and mechanisms, type 2 in diabetes older adults could soon be a manageable condition. It could be thus easily brought under effective control, unlike the previous years where it has become more of a death sentence to a significant majority, especially those in the United States.

References

Kirkman, M.S., Briscoe, V.J., Clark, N., Florez, H., Haas, L.B., Halter, J.B., …, & Swift, C.S. (2012). Diabetes in older adults: Diabetes Care; 35(12), 2650-2664.

Resnick, H.E., Heineman, J., Stone, R., & Shorr, R.I. (2004). Diabetes in U.S. nursing homes. Diabetes Care, 31(2), 287-288.