Acute hyperglycemic crisis in the elderly

Med Clin North Am. 2004 Jul;88(4):1063-84, xii. doi: 10.1016/j.mcna.2004.04.010.


The geriatric population is at particular risk for developing hyperglycemic crises with the development of diabetes. With increasing age, insulin secretory reserve, insulin sensitivity, and thirst mechanisms decrease. The elderly are particularly vulnerable to hyperglycemia and dehydration, the key components of hyperglycemic emergencies. If recognized early, hyperglycemia can frequently be treated in the outpatient setting even with moderate or large ketonuria, provided patients can take fluids, monitor blood glucose frequently, and follow standard "sick day rules." With increased diabetes surveillance and aggressive early treatment of hyperglycemia and its complications, morbidity and mortality from acute diabetic crises in the geriatric population can be greatly reduced.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Acute Disease
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Blood Glucose / drug effects
  • Critical Illness
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / diagnosis
  • Diabetes Mellitus, Type 2 / drug therapy
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Female
  • Geriatric Assessment
  • Humans
  • Hyperglycemic Hyperosmolar Nonketotic Coma / drug therapy*
  • Hyperglycemic Hyperosmolar Nonketotic Coma / epidemiology*
  • Hyperglycemic Hyperosmolar Nonketotic Coma / etiology
  • Infusions, Intravenous
  • Insulin / administration & dosage*
  • Male
  • Prognosis
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome


  • Blood Glucose
  • Insulin