The care of older adults with diabetes is complicated by their clinical and functional
heterogeneity. Some older individuals developed diabetes years earlier and
may have significant complications; others are newly diagnosed and may have had
years of undiagnosed diabetes with resultant complications; and still other older
adults may have truly recent-onset disease with few or no complications. Some
older adults with diabetes are frail and have other underlying chronic conditions,
substantial diabetes-related comorbidity, or limited physical or cognitive functioning.
Other older individuals with diabetes have little comorbidity and are active.
Life expectancies are highly variable for this population but are often longer than
clinicians realize. Providers caring for older adults with diabetes must take this heterogeneity
into consideration when setting and prioritizing treatment goals (Table 10.1).