Nutrition and Lifestyle Change in Older Adults with Diabetes Mellitus and Metabolic Syndrome

Abstract

In the USA, 44% of persons with self-reported diagnosed diabetes are aged 65 years or older and 18% are over age 75 years. The aim of diabetes intervention is to prevent or delay the development of long-term complications of high blood glucose and related metabolic abnormalities and improve the quality of life. "Metabolic syndrome" refers to a cluster of abnormalities that includes hypertension, dysilpidemia, abnormal blood glucose, and abdominal obesity. Over 40% of adults over the age of 70 have the metabolic syndrome. Hypoglycemia is a major limiting factor in the management of diabetes. Factors that may play a role in the increased risk of hypoglycemia in older adults include poor nutritional status, cognitive dysfunction, polypharmacy, and comorbid illnesses. Diabetes prevalence-related comorbidities such as diabetic retinopathy, cardiovascular disease, peripheral vascular disease, and congestive heart failure may result in decreased usual activity and limit activities of daily living, including transportation, shopping for food, and ability to read food labels and restaurant menus. Given the high rates of depression in the diabetes population, careful assessment of depressive symptomology and its impact on dietary intake, diabetes self-care, and health outcomes is critical.