Conclusions
My intention has been to suggest that there are enough subtle differences between diabetes in the old and that in young to make management of the former a speciality in its own right. Elderly patients with diabetes are likely to have not only complications of the disease but also other complicating diseases. To avoid adding iatrogenic complications requires a good knowledge of applied pharmacology as well as a carefully-designed treatment plan with a single named individual in overall charge. Many old people perceive diabetes as a matter of little concern [47] so that those looking after them must be especially diligent.
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References
Ellenberg M, Rifkin H (eds) (1983) Diabetes mellitus: theory and practice. 3rd edn. Medical Examining Publishing, New York
Krall LP (1982) World book of diabetes in practice. Excerpta Medica, Amsterdam Oxford Princeton
Harrower ADB (1980) Prevalence of elderly patients in a hospital diabetic population. Br J Clin Pract: 34: 131–133
Andres R (1971) Aging and diabetes. Med Clin North Am 55: 835–846
Keen H, Ng Tang Fui S (1982) The definition and classification of diabetes mellitus. Clin Endocrinol Metab 11: 279–305
Davidson MB (1979) The effect of aging on carbohydrate metabolism: a review of the English literature and a practical approach to the diagnosis of diabetes mellitus in the elderly. Metabolism 28: 688–705
Grobin W (1970) Diabetes in the aged: under-diagnosis and overtreatment. Can Med Ass J 103: 915–923
National Diabetes Data Group (1979) Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 28: 1039–1057
Keen H, Jarrett RJ, Alberti KGMM (1979) Diabetes mellitus: a new look at diagnostic criteria. Diabetologia 15: 283–286
Fuller JH, Elford J, Goldblatt P, Adelstein AM (1983) Diabetes mortality: new light on an underestimated public health problem Diabetologia 24: 336–341
Panzram G, Zabel-Langhennig R (1981) Prognosis of diabetes mellitus in a geographically defined population. Diabetologia 20: 587–591
Levin ME, O'Neal LW (1977) The diabetic foot. CV Mosby, St. Louis.
Whitehouse FW (1979) Saving a foot and salvaging a limb. Diabetes Care 2: 453–454
Bell ET (1957) Atherosclerotic gangrene of the lower extremities in diabetic and non-diabetic persons. Am J Clin Path 28: 27–36
Kohner EM, McLeod D, Marshall J (1982) Diabetic eye disease. In: Keen H, Jarrett RJ (eds) Complications of diabetes. Edward Arnold, London, p 19–108
Soler NG, Fitzgerald MG, Malins JM, Summers ROC (1969) Retinopathy at diagnosis of diabetes with special reference to patients under 40 years of age. Br Med J 2: 567–569
Wilson EA, Hadden DR, Merrett JD, Montgomery DAD, Weaver JA (1980) Dietary management of maturity-onset diabetes. Br Med J 1: 1367–1369
Kay RM, Grobin W, Track NS (1981) Diets rich in natural fibre improve carbohydrate tolerance in maturity-onset non-insulin-dependent diabetics. Diabetologia 20: 18–21
Logie AW, Galloway DB, Petrie JC (1976) Drug interactions and long-term anti-diabetic therapy. Br J Clin Pharmacol 3: 1027–1032
Seltzer HS (1972) Drug-induced hypoglycemia. A review based on 473 cases. Diabetes 21: 955–966
Frey HMM, Rosenlund B (1970) Studies in patients with chlorpropamide-induced hypoglycemia. Diabetes 19: 930–937
Asplund K, Wiholm BE, Lithner F (1983) Glibenclamide-associated hypoglycaemia: a report on 57 cases. Diabetologia 24: 412–417
Gale EAM, Dornan TL, Tattersall RB (1981) Severely uncontrolled diabetes in the over fifties. Diabetologia 21: 25–28
Barnett DM, Wilcox DS, Marble A (1961) Diabetic coma in persons over 60. Geriatrics 17: 327–336
Reaven GM (1981) Hyperlipidemia and hyperglycemia in elderly patients. In: Ebaugh FG (ed) Management of common problems in geriatric medicine. Addison-Wesley Publishing Co, New York, pp 2–14
Davidson MB (1982) Diagnosis and treatment of diabetes in the elderly. In: Brodoff BN, Bleicher SJ (eds) Diabetes mellitus and obesity. Williams and Wilkins, Baltimore, pp 566–576
Vaughan NJA, Matthews JA, Kurtz AB, Nabarro JDN (1983) Bioavailability of circulating antibody-bound insulin following insulin withdrawal in Type 1 (insulin-dependent) diabetes. Diabetologia 24: 355–358
Howe-Davies S, Simpson RW, Turner RC (1980) Control of maturity-onset diabetes by monitoring fasting blood glucose and body weight. Diabetes Care 3: 607–610
Bloom A (1977) Some practical aspects of the management of diabetes. Clin Endocrinol Metab 6: 499–517
Townsend C, Bailey J, Kohner EM (1980) Xenon-arc photocoagulation for the treatment of diabetic maculopathy. Br J Ophthalmol 64: 385–391
Kohner EM, Barry PJ (1984) Prevention of blindness in diabetic retinopathy. Diabetologia 26: 173–179
Savolainen EA, Lee QP (1982) Diabetic retinopathy — need and demand for photocoagulation and its cost effectiveness. Diabetologia 23: 138–140
Mapstone R (1977) Dilating dangerous pupils. Br J Ophthalmol 61: 517–524
Kini MM, Leibowitz HM, Colton T, Nickerson RJ, Ganley J, Dawber TR (1978) Prevalence of senile cataract, diabetic retinopathy, senile macular degeneration and open angle glaucoma in the Framingham eye study. Am J Ophthalmol 85: 28–34
Joslin EP (1934) The menace of diabetic gangrene. New Engl J Med 211: 16–20
Whitehouse FW, Jurgensen C, Block MA (1968) The later life of the diabetic amputee; another look at the fate of the second leg. Diabetes 17: 520–521
Kahn O, Wagner W, Bessman AN (1974) Mortality of diabetic patients treated surgically for lower limb infection and/or gangrene. Diabetes 23: 287–292
Editorial (1981) Management of patients with bilateral amputations. Br Med J 283: 684–685
Zorilla E, Kozak GP (1967) Ophthalmoplegia in diabetes mellitus. Ann Int Med 67: 968–976
Dornan TL, Espir MLE, Gale EAM, Worthington BS, Tattersall RB (1979) Remittent painful ophthalmoplegia — the Tolosa Hunt syndrome. J Neurol Neurosurg Psychiatr 42: 270–275
Chandler JR (1977) Malignant external otitis: further considerations. Ann Otol 86: 417–428
Zaky DA, Bentley DW, Lowy K, Betts RF, Douglas RG (1976) Malignant external otitis: a severe form of otitis in diabetic patients. Am J Med 61: 298–302
Mandel EE (1952) Renal medullary necrosis. Am J Med 13: 322–326
Editorial (1982) Renal papillary necrosis. Lancet 2: 588–590
Garland H (1955) Diabetic amyotrophy. Br Med J 2: 1287–1290
Ellenberg M (1974) Diabetic neuropathic cachexia. Diabetes 23: 418–423
Redmon JE, Thibault JM, Meador K (1982) Diabetes mellitus in the elderly. Postgrad Med J 71: 231–236
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Tattersall, R.B. Diabetes in the elderly — a neglected area?. Diabetologia 27, 167–173 (1984). https://doi.org/10.1007/BF00273800
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DOI: https://doi.org/10.1007/BF00273800