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Geriatrics
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Diabetes in the Elderly
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Diabetes in the Elderly

A special issue of Geriatrics (ISSN 2308-3417). This special issue belongs to the section "Geriatric Endocrinology and Metabolic Disorder".

Deadline for manuscript submissions: closed (31 December 2018) | Viewed by 15755

Special Issue Editor

Prof. Beatriz L. Rodriguez

E-Mail Website
Guest Editor
1. John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
2. Monterrey Institute of Technology School of Medicine, Monterrey, Mexico
Interests: diabetes and cardiovascular disease epidemiology and prevention

Special Issue Information

Dear Colleagues,

Diabetes in the elderly is a critical problem worldwide. According to the World Health Organization, the number of people living with diabetes has quadrupled since 1980 to 422 million adults or 8.5% of the population in 2014. The aging of the population is also an important factor in this diabetes epidemic. Most of these individuals with diabetes live in developing countries. The prevalence of diabetes is growing in all regions of the world. In the United States, the prevalence in adults age >65 is more than 25%. Some of the factors that contribute to this epidemic are obesity and overweight, as well as the lack of physical activity.

The complications of diabetes are many and include heart attack, stroke, blindness, kidney failure, neuropathy and lower limb amputations. In older adults, diabetes is linked also to higher mortality, cognitive dysfunction due to Alzheimer’s and multi-infarct dementia, reduced functional status and a higher risk of institutionalization. Older adults with diabetes often have several co-morbid conditions leading to geriatric syndromes which may interfere with their ability for self care, lower quality of life and adverse outcomes. Older adults with diabetes are also at increased risk of falls and fractures, in part due to balance problems due to neuropathy, hearing and vision deficits, muscle atrophy and other co-morbidities. Polypharmacy is another important issue in older adults with diabetes. This may lead to drug interactions and side effects. Depression is also associated to diabetes and may interfere with the ability of self care of elderly patients and with the implementation of desired lifestyle changes. Other problems in this population include meeting appropriate micronutrient needs, as their caloric intake needs are lower in the elderly. Women with diabetes also may suffer from urinary incontinence among other problems. In the US, diabetes is common in long term care facilities. The prevalence is 22% in Caucasian patients and 36% in non-Caucasian residents.

Given the alarming situation of this worldwide diabetes epidemic, we would like to dedicate a full Special Issue of the journal Geriatrics to scientific articles about Diabetes in the Elderly. The deadline for submission is 31 December, 2018. We look forward to receiving your manuscripts.

Prof. Beatriz L. Rodriguez
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Geriatrics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1800 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Diabetes in the elderly
  • Diabetes screening
  • Diabetes prevention
  • Lifestyle factors
  • Insulin resistance
  • Impaired Glucose Tolerance
  • Ethnicity
  • Glucose metabolism
  • Clinical Trials, Interventions
  • Inflammation
  • Obesity
  • Co-morbidities
  • Micro and Macrovascular Complications of diabetes in the elderly
  • Prediabetes
  • Polypharmacy
  • Health literacy in the elderly
  • Race/Ethnicity disparities

Published Papers (3 papers)

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Research

9 pages, 452 KiB  
Article
The Association of Fasting Glucose, Insulin, and C-Peptide, with 19-Year Incidence of Coronary Heart Disease in Older Japanese-American Men; the Honolulu Heart Program
by Nazneem Wahab, Randi Chen, Jess David Curb, Bradley Willcox and Beatriz L. Rodriguez
Geriatrics 2018, 3(2), 22; https://doi.org/10.3390/geriatrics3020022 - 22 Apr 2018
Cited by 2 | Viewed by 4144
Abstract
The role of fasting glucose, insulin levels, and C-peptide in coronary heart disease (CHD) in non-diabetic individuals remains uncertain. We examined the association between fasting glucose, insulin and C-peptide with the long-term incidence of CHD in Japanese-American men. In 1980–1982, from a [...] Read more.
The role of fasting glucose, insulin levels, and C-peptide in coronary heart disease (CHD) in non-diabetic individuals remains uncertain. We examined the association between fasting glucose, insulin and C-peptide with the long-term incidence of CHD in Japanese-American men. In 1980–1982, from a random sample of the Honolulu Heart Program men (n = 1378), aged 61–81 years, data on several CHD and metabolic risk factors were obtained to examine the relation of fasting glucose, insulin and C-peptide to 19-year CHD incidence. Age-adjusted incidence of CHD increased with increasing quintiles of glucose, insulin and C-peptide. Age-adjusted CHD rates in the glucose quintiles were 11.9, 11.6, 14.4, 18.1 and 24.1 per 1000 person-years (trend p < 0.001). In individual Cox models (lowest quintiles of glucose, insulin and C-peptide as reference) the relative risks (95% confidence interval) of CHD incidence for the glucose quintiles adjusting for age, smoking, hypertension, cholesterol, physical activity, and body mass index, were 0.9 (0.6–1.4), 1.2 (0.8–1.8), 1.4 (0.9–2.2), and 1.7 (1.1–2.6), respectively (trend p = 0.004). Insulin and C-peptide were not significantly associated with CHD on multivariate analysis. Fasting glucose remained the only significant predictor of increased CHD risk (p = 0.003) in a model combining all 3 metabolic variables. In this cohort, only fasting glucose independently predicts long-term incidence of CHD. Age-adjusted insulin and C-peptide levels were associated with CHD incidence, but after adjustment for other risk factors, do not independently predict CHD. Full article
(This article belongs to the Special Issue Diabetes in the Elderly)
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8 pages, 358 KiB  
Article
Effects of Walking on Coronary Heart Disease in Elderly Men with Diabetes
by Chieko Kimata, Bradley Willcox and Beatriz L. Rodriguez
Geriatrics 2018, 3(2), 21; https://doi.org/10.3390/geriatrics3020021 - 19 Apr 2018
Cited by 6 | Viewed by 6298
Abstract
Previous studies have shown that walking is associated with increased longevity and a reduced risk of cardiovascular and age-related diseases. Whether walking benefits individuals with diabetes who are at high risk of coronary heart disease (CHD) remains to be determined. The objective of [...] Read more.
Previous studies have shown that walking is associated with increased longevity and a reduced risk of cardiovascular and age-related diseases. Whether walking benefits individuals with diabetes who are at high risk of coronary heart disease (CHD) remains to be determined. The objective of this study is to examine the association between walking and risk of CHD among elderly men with and without diabetes. Walking data was assessed in 2732 men aged 71 to 93 years participating in the Honolulu Heart Program from 1991–1993. Study participants were initially without disabilities and free of prevalent CHD. Men were then followed for incident CHD for up to 7 years. For men with diabetes who walked <0.25 miles/day, the age-adjusted incidence of CHD was significantly higher than in men without diabetes (27.1 vs. 12.7/1000 person years, p = 0.026). In contrast when distance walked was >1.5 miles/day, incidence of CHD was similar in men with and without diabetes (12.2 vs. 9.1/1000 person-years, p = 0.46). While risk of CHD declined significantly with increasing walking distance in men with diabetes after age and risk factor adjustment (p = 0.043, p = 0.025), associations in those without diabetes were weaker (p = 0.070, p = 0.10). These findings suggest that among elderly men with diabetes who are capable of physical activity, walking reduces CHD risk to levels similar to when diabetes is absent. Walking is an easy, safe and accessible form of physical activity that may have marked health benefits for elderly men with diabetes. Full article
(This article belongs to the Special Issue Diabetes in the Elderly)
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13 pages, 1943 KiB  
Article
The Relationship of 5-Aminolevulinic Acid on Mood and Coping Ability in Prediabetic Middle Aged and Older Adults
by Rachael K. Aquino, Michael Perez, Payel Sil, Terry Shintani, Rosanne Harrigan and Beatriz Rodriguez
Geriatrics 2018, 3(2), 17; https://doi.org/10.3390/geriatrics3020017 - 4 Apr 2018
Cited by 3 | Viewed by 4776
Abstract
In 2010, approximately 79 million Americans had prediabetes and about 50 percent of those individuals were 65 years and older. The most effective diabetes prevention method in prediabetic adults is lifestyle modification. However, despite the benefits of lifestyle change, diabetes prevalence continues to [...] Read more.
In 2010, approximately 79 million Americans had prediabetes and about 50 percent of those individuals were 65 years and older. The most effective diabetes prevention method in prediabetic adults is lifestyle modification. However, despite the benefits of lifestyle change, diabetes prevalence continues to increase. Maintaining a regular exercise routine and a healthy eating plan may be difficult because of the negative emotional barriers (i.e., stress, mood) that a prediabetic individual faces. This is particularly evident in older individuals when you combine that with decreases in mobility and geriatric syndromes. A potential treatment for these emotional barriers is a natural supplement called 5-aminolevulinic acid (5-ALA). In the current study, the group included 154 participants, both men and women, ranging between the ages of 41 to 71 years old. The study design was a double-blind, randomized parallel-group study. The Psychosocial Depressive Symptoms Questionnaire (PDS) and the Perceived Stress Scale (PSS) were used to examine the effect of two doses of 5-ALA (15 mg and 50 mg) on various components of mood (i.e., hopefulness, loneliness, and motivation) and coping ability. Using SAS software, an ordered logistic regression model was used to analyze the association between the dose groups (control, 15 mg, and 50 mg) and the responses to the two questionnaires, the PDS and PSS, used in this study. An integrative literature review, using the PubMed database, searched for studies on the relationship between 5-ALA administration and mood and coping ability. Our literature review resulted in zero published articles. Next, we found that the intake of 5-ALA was significantly associated with improved coping ability (p = 0.004) and improved self-perception of effort spent (p = 0.002). Finally, we found a significant dose-dependent relationship for the association of 5-ALA intake on measures of effort (p = 0.003), loneliness (p = 0.006), and coping ability (p = 0.003). The 50 mg dose was more effective than the 15 mg dose in improving these measures. In conclusion, after 12 weeks of taking 5-ALA, we found significant improvements in self-perception of effort spent, loneliness, and coping ability in prediabetic middle age and older adults. Improved mood and coping ability may allow prediabetic individuals to overcome the emotional obstacles preventing them from maintaining a healthy lifestyle and ultimately, help them to avoid the development of diabetes. Full article
(This article belongs to the Special Issue Diabetes in the Elderly)
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