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begins in the third decade and continues to progress particularly associated with obesity,
lifestyle, sedentary lifestyle, poor nutritional habits and genetics.
For many years, it has been investigated similarity between the aging process and the changes
observed in the tissues of a diabetic patient. The most characteristic element common to both
processes is the development of atherosclerosis with aging and premature development of this
condition in the diabetic patient. Several findings that favor a model of diabetes as aging,
particularly microscopically observed changes in the organs, and acceleration of these changes
in kidney tissues and organs, peripheral nerves, blood vessels and collagen in diabetic patient.
When comparing both processes, changes occur early and are more severe in diabetic patients
and can be observed in the pre-diabetic condition of glucose intolerance. Early detection and
strict glycemic control to prevent or delay these progressive changes is emphasized then.
The pathogenesis of diabetes in the elderly has been studied extensively in the last forty years
and is multifactorial. Factors have been implicated such as insulin deficiency, insulin resistance,
structural changes in pancreatic cells with impaired secretion and action of hormones such as
insulin, glucagon and other pancreatic hormones are still in research, decreased utilization
Peripheral glucose, changes in body composition with an increase in the percentage of fat,
dietary changes and physical activity are seen as advance in age.
The pathophysiology of complications is similar in elderly patients and in young adults.
However, the physiological changes that occur with aging in addition to the changes by diabetes
lead to a decrease in physiological reserve that affects the functional capacity and
independence of the geriatric patient. Uncontrolled diabetes in this age group favors geriatric
syndromes incontinence, falls, frailty, polypharmacy, cognitive impairment, depression and
limitation of mobility and independence that is three times higher in this group, and a limitation
in activities of daily living twice more common in younger diabetic. Therefore, it must be
emphasized early detection of this condition and its strict control preventing hypoglycemia with
nutritional guidance and a plan and schedule appropriate meals. In the comprehensive
treatment of 65 elderly individual assessment to include in addition to psychosocial aspects and
medical comorbidities, functional aspects, evaluation for detecting geriatric syndromes
associated, prevention and management of cardiovascular risk, individualized patient education
is essential and next of kin, strict control of blood sugar, increase physical activity and eliminate
harmful habits.
Diagnoses of the American Diabetes Association criteria do not include adjustments for age
diagnostic values. These criteria apply to the general population.
SECRETARA DE EDUCACIN
SUBSECRETARA DE EDUCACIN MEDIA
SUPERIOR Y SUPERIOR
PLAZA SAN JACINTO, SAN PEDRO Y DE LA VILLA DE MADRID S/N, COL. PLAZAS DE ARAGN, CD. NEZAHUALCYOTL ESTADO DE MXICO
C.P. 57139
With respect to therapeutic targets, glycosylated hemoglobin should be less than 7 and very
close to 6.5%. Fasting glucose should range between 90-100 mg / dl avoiding fasting
hypoglycemia, postprandial value should not exceed 180 mg / dl and the therapeutic regimen
should be adjusted to the lifestyle and the fragility of the individual. Currently there are many
drugs with complementary mechanisms of action, aimed at the pathophysiology of diabetes
mellitus that promote better glycemic control individualized. In the geriatric population it is very
encouraging to see individuals who are active exercising, in voluntary work, or practicing their
hobbies and collaborating with the health team enjoying a healthy old age what life offers every
day.
SECRETARA DE EDUCACIN
SUBSECRETARA DE EDUCACIN MEDIA
SUPERIOR Y SUPERIOR
PLAZA SAN JACINTO, SAN PEDRO Y DE LA VILLA DE MADRID S/N, COL. PLAZAS DE ARAGN, CD. NEZAHUALCYOTL ESTADO DE MXICO
C.P. 57139
La Diabetes y el envejecimiento
La Diabetes mellitus es un desorden metablico caracterizado por hiperglucemia secundaria a
la deficiencia relativa de insulina o de su accin resultante en el desarrollo de cambios
degenerativos en los nervios perifricos, el ojo, el rin y en complicaciones macro vasculares
que afectan el corazn, el cerebro y la circulacin perifrica. Para prevenir estas
complicaciones es importante enfatizar la deteccin temprana y el control Glucmico estricto en
todos los individuos independientemente de su edad.
El proceso de envejecer envuelve una regresin fisiolgica del organismo a travs del tiempo y
es importante reconocer que el control glucemico y el manejo de la diabetes en esta poblacin
debe incluir un estimado de la capacidad funcional, fragilidad, expectativas de vida y
comorbilidades para evitar complicaciones de hipoglucemia y retardar las complicaciones de la
enfermedad.
La Diabetes es una de las condiciones crnicas comunes que afecta al envejeciente. La
prevalencia de esta condicin en la poblacin mayor de 65 aos flucta entre un 15% y un
20%. En Estados Unidos, la poblacin mayor de 65 aos representa un 40% de la poblacin
con Diabetes y la prevalencia es mayor en los grupos tnicos de negros americanos e hispanos
americanos con una severidad de complicaciones mayor en la raza negra. En Puerto Rico, la
prevalencia de Diabetes en la poblacin mayor de 65 aos se ha estimado en 26% para el
2006.
La Diabetes puede permanecer asintomtica por muchos aos e incluso muchas personas
consideran la hiperglucemia como parte del envejecimiento, y aproximadamente un tercio de la
poblacin mayor de 65 aos desconoce su condicin. En un 90% de los casos estos individuos
padecen Diabetes mellitus tipo 2 y por muchos aos su organismo ha sufrido un estado de prediabetes con intolerancia a la glucosa, resistencia a la insulina y el sndrome metablico con la
aceleracin en el riesgo de arteriosclerosis y el eventual desarrollo de Diabetes mellitus tipo 2.
En ocasiones al interrogar a nuestros pacientes sobre el historial de Diabetes en la familia, la
respuesta inmediata es: "No hay Diabetes, solo aquella que llega con la edad"...es interesante
observar que la Diabetes en la edad madura y avanzada no es importante para algunas
personas pues la consideran un cambio propio del proceso de envejecer... Es muy importante
aclarar este concepto y revisar los cambios en el metabolismo de glucosa con el
envejecimiento y las estrategias de control y prevencin de complicaciones que aplican a esta
poblacin.
SECRETARA DE EDUCACIN
SUBSECRETARA DE EDUCACIN MEDIA
SUPERIOR Y SUPERIOR
PLAZA SAN JACINTO, SAN PEDRO Y DE LA VILLA DE MADRID S/N, COL. PLAZAS DE ARAGN, CD. NEZAHUALCYOTL ESTADO DE MXICO
C.P. 57139
aos es esencial una evaluacin que incluya en adicin a los aspectos mdicos y
comorbilidades, aspectos funcionales, psicosociales, evaluacin para la detectar sndromes
geritricos asociados, prevencin y manejo de riesgo cardiovascular, Educacin
individualizada al paciente y al familiar ms cercano, control estricto de la glucemia, aumentar
la actividad fsica y eliminar hbitos txicos.
Los criterios diagnsticos de la Asociacin Americana de Diabetes no incluyen ajustes para los
valores diagnsticos con la edad. Estos criterios, aplican a la poblacin general.
Con relacin a las metas teraputicas, la hemoglobina glucosilada debe ser menor de 7 y muy
cerca de 6.5%. La glucosa en ayunas, debe fluctuar entre 90-100 mg/dl en ayunas evitando la
hipoglucemia, el valor postprandial no debe exceder 180 mg/dl y el rgimen teraputico debe
ajustarse al estilo de vida y la fragilidad del individuo. Actualmente existen mltiples
medicamentos con mecanismos de accin complementarios, dirigidos a la patofisiologa de la
Diabetes mellitus que favorecen un mejor control glucmico individualizado. Dentro de la
poblacin geritrica es muy estimulante observar individuos que se mantienen activos
ejercitndose, en labor voluntaria, o practicando sus pasatiempos y colaborando con el equipo
de salud en una vejez saludable disfrutando lo que la vida les ofrece cada DIA.
SECRETARA DE EDUCACIN
SUBSECRETARA DE EDUCACIN MEDIA
SUPERIOR Y SUPERIOR
PLAZA SAN JACINTO, SAN PEDRO Y DE LA VILLA DE MADRID S/N, COL. PLAZAS DE ARAGN, CD. NEZAHUALCYOTL ESTADO DE MXICO
C.P. 57139
VOZ PASIVA
1 Diabetes mellitus is a metabolic disorder characterized by hyperglycemia secondary to
relative deficiency of insulin
2 Diabetes is a common chronic conditions an affected
the aging
3Diabetes is a disease that has confused many people as they remain asymptomatic for many
years and even many people consider hyperglycemia as part of aging.
4The pathophysiology is one of the complications that aroused so similar in elderly patients
and in young adults.
5Diabetes mellitus is the most read and the most common heart disease death in Mexico
6Geriatric patients are those with the most evident often disabled
SECRETARA DE EDUCACIN
SUBSECRETARA DE EDUCACIN MEDIA
SUPERIOR Y SUPERIOR
PLAZA SAN JACINTO, SAN PEDRO Y DE LA VILLA DE MADRID S/N, COL. PLAZAS DE ARAGN, CD. NEZAHUALCYOTL ESTADO DE MXICO
C.P. 57139