How to treat diabetes in the elderly?

Written by Zhou Yan

Geriatrics

Updated on March 19, 2025

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For elderly patients with diabetes, our long-term treatment goal is to delay the onset and progression of chronic diabetic complications, maintain good health and self-care ability, improve quality of life, and extend healthy lifespan through good metabolic control. The short-term goal is to control hyperglycemia and its metabolic disorders, eliminate the symptoms of diabetes, and prevent acute severe metabolic disorders. Our "five-pronged" approach to diabetes management is also suitable for elderly patients, including diabetes education, medical nutrition therapy, exercise therapy, blood glucose monitoring, and medication therapy. Therefore, for elderly diabetic patients, it is essential to keep blood glucose levels within a controllable range, delay the onset of complications, and provide a healthy twilight years for elderly diabetics.

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Written by Zhao Dan

Orthopedics

2min 5sec

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Gestational diabetes standards

Before addressing this question, let's first clarify another concept: if diabetes is diagnosed before pregnancy, this is referred to as pre-existing diabetes in pregnancy, which is different from gestational diabetes. Gestational diabetes refers to cases where there is no pre-existing diabetes diagnosis before pregnancy, but abnormal blood glucose levels are detected after becoming pregnant. Generally, a glucose screening test is conducted between the 24th and 28th weeks of pregnancy. Currently in China, there are two approaches: the one-step and the two-step methods. The one-step method involves a direct 75-gram oral glucose tolerance test. However, most of China uses the two-step method, which starts with a 50-gram glucose challenge test. If the blood glucose level one hour after eating is greater than or equal to 7.8 mmol/L, a 75-gram oral glucose tolerance test is recommended. For the 75-gram glucose test, the fasting blood glucose level should generally be less than or equal to 5.6 mmol/L, one hour post-glucose intake should be 10.3 mmol/L, two hours post-glucose should be 8.6 mmol/L, and three hours post-glucose should be 6.7 mmol/L. If two or more of these values exceed the diagnostic criteria, gestational diabetes can be diagnosed. If only one value is abnormal, impaired glucose tolerance can be diagnosed. It is recommended that anyone who experiences abnormal blood glucose levels during pregnancy undergo another 75-gram oral glucose tolerance test six months post-pregnancy to determine if blood glucose levels are still abnormal and whether treatment should continue.

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Written by Chen Li Ping

Endocrinology

1min 13sec

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What is gestational diabetes like?

Gestational diabetes refers to diabetes that appears during pregnancy, or is detected during pregnancy, or is an abnormal glucose tolerance of any degree. Gestational diabetes affects both the pregnant mother and the fetus. Although the mortality rate of pregnant women with gestational diabetes has significantly decreased, complications are still quite common. It may increase the rate of spontaneous miscarriages and preterm births for fetuses. Secondly, it can cause fetal or neonatal death, and intrauterine growth retardation. Thirdly, it leads to excessive amniotic fluid and macrosomia, and may result in neonatal polycythemia, fetal malformations, neonatal respiratory distress syndrome, neonatal hypoglycemia, as well as neonatal hypocalcemia and hypomagnesemia. For the mother, it can lead to pregnancy-induced hypertension syndrome, infections during pregnancy or childbirth, and in severe cases, diabetic ketoacidosis.

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Written by Lin Xiang Dong

Endocrinology

48sec

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Gestational diabetes range

Gestational diabetes refers to abnormal blood sugar levels occurring during pregnancy. This term is used if the diagnosis is made during pregnancy, and does not include patients who were already diabetic before pregnancy, who are referred to as having diabetes concurrent with pregnancy. The criteria for diagnosing gestational diabetes are based on the results of the OGTT (Oral Glucose Tolerance Test) conducted between 24-28 weeks of pregnancy. According to the OGTT results, a fasting blood sugar level ≥ 5.1 mmol/L, a one-hour blood sugar level ≥ 10.0 mmol/L, or a two-hour blood sugar level ≥8.5 mmol/L, meeting any one of these criteria confirms a diagnosis of gestational diabetes.

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Written by Zhao Li Li

Obstetrics

43sec

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What should pregnant women with diabetes eat?

If a pregnant woman has been diagnosed with gestational diabetes during pregnancy, it is still necessary to decide what food to eat based on the specific blood sugar levels. If the current blood sugar level is relatively stable, she can follow a diabetic diet, eat smaller meals more frequently, and consume more fresh fruits and vegetables. It's important to avoid foods that cause high blood sugar, and it is essential to walk or engage in appropriate exercise 30 minutes after eating to help metabolize the blood sugar. However, if the blood sugar remains high and does not decrease significantly, insulin might be needed to lower the blood sugar levels.

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Written by Zhou Yan

Geriatrics

56sec

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Symptoms of diabetes in the elderly

Elderly diabetes often begins inconspicuously, lacking the typical symptoms of excessive thirst, urination, hunger, and weight loss. It can present with various complications such as diarrhea, constipation, urinary retention, limb numbness, skin itching, and shoulder joint pain. Elderly diabetics often have concurrent infections, particularly in the respiratory and urinary systems, as well as cholecystitis and skin infections. They may also suffer from ketoacidosis, hyperosmolar hyperglycemia syndrome, and coexist with multiple chronic diseases of old age such as heart failure, coronary heart disease, hypertension, and hyperlipidemia. They require different types of medications and are susceptible to hypoglycemia, making timely diagnosis and treatment challenging. These are the symptoms of diabetes in the elderly.