New Diabetes Guidelines

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Latest Diabetes GuidelinesThe risk of developing this very common chronic disorder increases as you age. There are two different types of diabetes. The first is type 1 which involves children and the second and by far the most common is type 2 diabetes which affects adults. The cause of type 1 diabetes is an autoimmune defect whereupon your body makes specialized proteins called antibodies which attack and destroy the cells in your pancreas that make and secrete insulin. Insulin is a hormone required to control your level of blood sugar.

Type 2 diabetes is caused by chronic obesity, poor diet, low levels of physical activity, insulin resistance, and inflammation. This situation eventually causes the beta cells of your pancreas permanent damage resulting in sustained high levels of blood sugar. Now, some new guidelines regarding the prevention of type 2 diabetes have recently been presented by the International Diabetes Federation. This report, which was designed for adults over the age of 70 years, was presented at the World Diabetes Congress.

“The key messages are prevention—by proactively making risk assessments and screening to minimize risks, planning care around functional status, namely mental and physical competence, and the imperative to individualize that care,” said study author, Dr. T. Dunning.  “In older people, assessments should often be more frequent than they are in younger patients. Older people do very well until something goes wrong, and then they often deteriorate suddenly, so those assessments might need to be more frequent than the annual ones we normally do. Finally, but also of extreme importance is the issue of managing medicines.”

This information is extremely important as people who are over the age of 70 can develop type 2 diabetes very insidiously and they often are not aware of this. The symptoms can be very vague and generalized leading their health care providers to believe that they have some other health issue. A simple urine sample followed by some basic blood testing can easily demonstrate the diagnosis.

Of particular importance in these comments is the fact that the health status of these patients can very often deteriorate rapidly if their blood sugar is elevated for even short periods of time. Also concerning is the issue regarding the overprescribing of medications in this demographic of patients. Quite frequently, people who are over 70 may be on multiple medications and may be at an increased risk of adverse effects when new medications are introduced despite the reasons.

“The one thing that doesn’t happen as often as it should is stopping medicines—not just keeping on prescribing [more and more] medicines. In older people, a lot of medicines are contraindicated or there are precautions to using them. So a comprehensive medicines assessment and stopping treatment, where possible, is an imperative part of the assessment process,” Dr. Dunning said.

I could not agree more with this advice!

The key messages here are prevention and regular assessments of people over 70 who are at an increased risk of developing type 2 diabetes. Prevention strategies are the same regardless of age and could include weight loss, dietary changes, and an increase in physical activity levels.

Nainggolan, L., “New IDF Guidelines Target Diabetes Care in the Elderly,” Medscape web site, Dec.16, 2013;

International Diabetes Federation website;, last accessed Dec. 16, 2013.