



































Special Edition: Junior Clinical Research (2022), Vol. 2 No. S2 
 https://doi.org/10.47488/dhrp.v2iS2.66 

 

 

 
 
 DHR Proceedings ǀ http://dhrproceedings.org  49 2022, Vol. 2 No. S2 49-54 
   

 

COMMENTARY 

Type 2 Diabetes and its Effect on the Elderly 

Population 
 
Gonzalo Aleman 1, 2, Mayte Aleman 1, 2, Vicente Garcia 1, 2, Brisaeda Guerrero 1, 2 Mareli Cuellar 1, 3, 

Brandy Guerrero 1, 3, Meranda Martinez 1, 3 
 

1 2ndAnnual Junior Clinical Research Internship, South Texas Academy for Education & Training in Research, DHR Health 

Institute for Research & Development 
2 Los Fresnos High School, Los Fresnos, TX 
3 Weslaco East High School, Weslaco, TX 

 
All correspondence should be addressed to Program Director, 2nd Annual Junior Clinical Research Internship Program, DHR 

Health Institute for Research & Development, 5323 S McColl Road, Edinburg Texas, 78539 

 

Received 07/21/2022 

Accepted for publication 08/03/2022 

Published 08/03/2022 

 

 

Introduction 

 
In 1500 B.C, Egyptians’ scripts helped 

researchers discover that Indian doctors called 

diabetes, madhumeha, since ants were attracted to 

urine from certain individuals [1]. Later in 400-500 

A.D, Indian physician, Sushruta, and surgeon, 

Charaka, recognized that there were two types, Type I 

and Type II diabetes [1]. In 1978, British surgeon, 

John Rollo, originated the word mellitus, which helped 

him discover that diabetes had another attribute, 

diabetes insipidus [1]. Diabetes insipidus is the 

creation of enormous amounts of weak, thin urine due 

to the kidneys not properly concentrating the urine, 

which is mostly produced because of dehydration and 

thirst [2].  However, diabetes mellitus (Type I & Type 

II) is when the pancreas can’t generate enough insulin 

to manage glucose levels in the blood [2]. In Type I 

diabetes, the pancreas isn’t making the right amount of 

insulin to help the glucose stabilize and enter the cell 

[2]. Individuals with Type I diabetes develop 

symptoms such as losing weight, urinating a lot, and 

being very thirsty [3]. Type II diabetes is a more 

complicated disorder that includes the pancreas, 

insulin system, liver, kidneys, gut, muscle, fat cells, 

and brain [4]. Type II diabetes symptoms are increased  

 

 

thirst, fatigue, blurred vision, and extreme weight loss 

[5]. 

 
 Type II Diabetes 

 
Type II diabetes has affected the population 

with high rates of diabetes-related morbidity and 
mortality. Type II diabetes is a chronic disease in 

which your blood glucose is high. Glucose is the main 

source of energy that comes from the food that 

someone eats [6]. A hormone called insulin helps the 

cells receive energy from the glucose, but over time 

having a lot of glucose in your blood can cause health 

problems. Some health problems that elderly people 

can develop are heart disease, kidney disease, dental 

disease, and nerve damage.  

 
Development and Symptoms of Type II 

Diabetes 

 
Type II diabetes may be caused by being 

overweight, not being physically active, or the 

genetics of your family. Having extra weight can cause 

insulin resistance and Type II diabetes usually starts 

with insulin resistance. Insulin resistance is when cells 

in the muscles, fat, and liver don’t respond well to 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749019/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749019/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749019/
https://pubmed.ncbi.nlm.nih.gov/8575409/
https://pubmed.ncbi.nlm.nih.gov/8575409/
https://pubmed.ncbi.nlm.nih.gov/8575409/
https://www.cdc.gov/diabetes/basics/what-is-type-1-diabetes.html
https://pubmed.ncbi.nlm.nih.gov/27262256/
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
https://medlineplus.gov/diabetestype2.html#cat_95


Aleman, et al. Type 2 Diabetes in Elderly 

  https://doi.org/10.47488/dhrp.v2iS2.66 

 

 
 
 DHR Proceedings ǀ http://dhrproceedings.org  50 2022, Vol. 2 No. S2 49-54 
   

insulin and can’t easily take up glucose from the blood 

[7]. As a result, the pancreas makes more insulin to 

make the cells receive the glucose it needs. Over time, 

the pancreas will not be able to make enough insulin 

and the blood glucose levels will rise [7]. Type II 

diabetes symptoms include an increase in hunger, 

thirst, and urination. It also includes blurred vision, 

sores that don’t heal, and numbness or tingling in the 

feet or hands [8]. 

 
Risk Factors of Type II Diabetes  

 
Type II diabetes affects all people around the 

world, including, Hispanics/Latinos, African 

Americans, and Alaska Natives. This is due to genetic, 

environmental, and metabolic risk factors. The 

majority of the population has been at high risk of 

developing Type II diabetes because of poor 

alimentation and physical inactivity. Genetics and 

lifestyle are the main risk factors that lead to the 

development of Type II diabetes. People with insulin 

resistance can have the same risk factors as Type II 

diabetes patients. The development of risk factors can 

help individuals have early detection and treatment 

and reduce later complications.  [9-10]. 

 
Type II Diabetes Diagnosis  

 
Type II diabetes is diagnosed to help 

individuals reduce and manage the glucose levels in 

the body. It is diagnosed by taking blood tests which 

help the doctors determine if blood sugar is high or 

low. There are four different tests that can evaluate the 

blood glucose level: A1C, Fasting Plasma Glucose 

(FPG), Oral Glucose Tolerance Test (OGTT), and 

Random Plasma Glucose Test. The A1C test 

calculates the blood sugar from the previous two or 

three months [11]. The A1C test is a blood test where 

blood is drawn from the vein in your arm and then they 

are sent to a lab for analysis [12].  The Fasting Plasma 

Glucose test examines the glucose by not having 

anything to eat or drink for a minimum of 8 hours 

before the test and this test is done in the morning prior 

to breakfast [11]. The Oral Glucose Tolerance Test 

checks the blood glucose levels before and two hours 

after drinking a high-sugary drink which helps the 

doctor determine the way your body metabolizes sugar 

[11]. The Random Plasma Glucose Test is tested on 

individuals that have critical diabetes symptoms and is 

diagnosed at any moment throughout the 7day [11]. In 

addition, this test is done by a puncture in the finger to 

draw a small amount of blood and is then put onto a  

test strip which will give the glucose levels [13].  

 

Prevalence of Type II Diabetes 

 
Diabetes is a worldwide epidemic, affecting 

415 million people and about 193 million undiagnosed 

[14]. It affects 25% of the population of people over 

the age of 65, and the percentage continues to increase 

rapidly [15]. According to the American Diabetes 

Association, in 2019, 37.3 million Americans, or 

11.3% of the population had diabetes. The percentage 

of Americans 65 and older remains high at 29.2% or 

15.9 % of million seniors (diagnosed and undiagnosed, 

respectively) [16]. In the United States, diabetes is the 

seventh leading cause of death, and approximately 

95% percent of 37 million Americans have Type II 

diabetes [17-18]. Among these patients, adults over 65 

years of age are more prevalent to develop Type II 

diabetes because of natural insulin decrease. The rates 

of Type II diabetes steadily increase in age, but it can 

be developed at any time. It is important to be aware 

of the circumstances and symptoms of Type II 

diabetes, whether you’re healthy or not. Managing 

diabetes is crucial because it can cause serious health 

problems over time like heart disease, stroke, kidney 

disease, eye problems, and nerve damage that can 

possibly lead to amputation. Along with health 

problems, patients with Type II diabetes have a greater 

risk for cancer and Alzheimer’s disease [19]. 

 

Living in a state that has one of the highest 

rates of diabetes that constantly exceeds the national 

average, Texas, the concern on diabetes is a constant 

issue [17]. In addition, the circumstances of living in 

an area that has the highest rates of obesity in the 

country comes with many health concerns, along with 

the prevalence of diabetes [20]. The Rio Grande 

Valley faces a burden of high rates of diabetes that are 

almost three times as high as the general population of 

the United States [21].  

 

A study from UTRGV compared diabetes 

prevalence in the Rio Grande Valley’s four counties 

with the United States between the years 2004-2017 

[22]. Results show that the prevalence of diabetes in 

the United States increased by 1.5% while the Rio 

Grande Valley’s prevalence increased by 6.33%. The 

highest increase within the Rio Grande Valley was in 

Willacy County with an increase of 11.6%. The study 

did not differentiate between the 2 types of diabetes, 

however, 95% of the diabetic cases account for Type 

II diabetes [22].  

 

On the other hand, the Rio Grande Valley is 

populated by 91.5% of Hispanics, as of 2019, and 

statistics from the CDC show that Hispanic or Latino 

people are 17% more likely to develop type 2 diabetes 

https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance
https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance
https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes#type
https://www.niddk.nih.gov/health-information/diabetes/overview/risk-factors-type-2-diabetes
https://journals.lww.com/jcnjournal/Abstract/2002/01000/Risk_Factors_for_Type_2_Diabetes_Mellitus.3.aspx
https://www.diabetes.org/diabetes/a1c/diagnosis
https://www.niddk.nih.gov/health-information/diagnostic-tests/a1c-test
https://www.diabetes.org/diabetes/a1c/diagnosis
https://www.diabetes.org/diabetes/a1c/diagnosis
https://www.diabetes.org/diabetes/a1c/diagnosis
https://www.healthline.com/health/type-2-diabetes/random-glucose-testing#:~:text=It's%20usually%20done%20by%20pricking,the%20disease%20is%20being%20managed.
https://pubmed.ncbi.nlm.nih.gov/28190580/
https://pubmed.ncbi.nlm.nih.gov/21890292/
https://www.diabetes.org/about-us/statistics/about-diabetes
https://txohc.org/communication/data-dashboard/diabetes/#:~:text=According%20to%20the%20U.S.%20Diabetes,%25%20and%20Wichita%20at%2012.3%25
https://www.cdc.gov/diabetes/basics/type2.html#:~:text=Healthy%20eating%20is%20your%20recipe,them%20have%20type%202%20diabetes
https://www.nia.nih.gov/health/diabetes-older-people#:~:text=It's%20important%20to%20manage%20diabetes,for%20cancer%20and%20Alzheimer's%20disease
https://txohc.org/communication/data-dashboard/diabetes/#:~:text=According%20to%20the%20U.S.%20Diabetes,%25%20and%20Wichita%20at%2012.3%25
https://shmabstracts.org/abstract/obesity-and-in-patient-hospital-covid-19-outcomes-in-the-rio-grande-valley-of-texas/#:~:text=Additionally%2C%20the%20RGV%20has%20one,to%20the%20high%20mortality%20rate
https://www.valleycentral.com/news/local-news/rate-of-diabetes-in-the-rgv-remains-high-health-officials-urging-healthy-habits/#:~:text=Photo
https://scholarworks.utrgv.edu/som8127/4/
https://scholarworks.utrgv.edu/som8127/4/


Aleman, et al. Type 2 Diabetes in Elderly 

  https://doi.org/10.47488/dhrp.v2iS2.66 

 

 
 
 DHR Proceedings ǀ http://dhrproceedings.org  51 2022, Vol. 2 No. S2 49-54 
   

than non-Hispanic people, which is 8% [23-24]. Along 

with a higher risk, Hispanic or Latino adults have a 

more than 50% chance of developing Type II diabetes 

[24]. The same study from UTRGV displays another 

comparison on the prevalence of diagnosed diabetes in 

the United States between Hispanic and Non-Hispanic 

White, Black, and Asian race-ethic groups. The 

outcome of the study shows that Hispanics have one 

of the highest prevalence among the race-ethnic 

groups with an increase of 2.4% [22]. The statistics 

highlight the importance of continuing to evaluate all 

populations; specifically, the elderly who are affected 

by Type II diabetes. 

 
Frailty in Elderly Patients with Diabetes 

 
Type II diabetes in older patients has become 

a concern because it leads to falls, disability, 

hospitalization, care home admission, and even 

mortality [25]. Elderly patients with type II diabetes 

face various complications that include triopathy, 

retinopathy, neuropathy, nephropathy, and 

macrovascular complications. Diabetes has been a risk 

factor for older people which develops a physical 

disability, bone fractures, cerebrovascular disease, 

heart disease, and hypertension [26]. Frailty includes 

damage to older patients’ eyesight, physical, and 

mental disabilities.  

 

Frailty is the loss of homeostasis and 

vulnerability to various stressors. The presence of 

frailty in a diabetic patient causes deterioration in 

muscle and nerve function [26]. Frailty is not only the 

physical incompetence of a person but also the 

psychological complexity. For example, patients with 

type II diabetes tend to suffer from depression, stress, 

and poor eating habits [27]. Sarcopenia is an age-

related, involuntary loss of skeletal muscle mass and 

strength. Diabetes causes an increase in sarcopenia in 

older patients, it will deteriorate muscle mass and 

strength faster. [28] 

 

Diabetic retinopathy is an eye condition that 

causes vision loss and blindness in people who have 

diabetes. Symptoms of diabetic retinopathy include 

dark, floating spots or streaks that look like cobwebs. 

This is caused by blood vessels in the retina starting to 

bleed into the vitreous. Although these spots can clear 

on their own, it is important to get treatment to avoid 

scarring. Doctors test patients with diabetes using a 

test called fluorescein angiogram which presents 

pictures of the blood vessels in a retina [29]. In order 

to avoid diabetic retinopathy patients must manage 

their diabetes. Keeping their blood sugar at a healthy 

range and consistently visiting their doctors can help 

them avoid getting diabetic retinopathy. Older patients 

must maintain a regular routine of physical activity, 

eat healthily, and carefully follow their doctor’s 

instructions on insulin intake and other diabetes 

medicines. Treatments used for diabetic retinopathy 

include injections, laser treatment, and eye surgery 

[30]. 

 

Cardiovascular disease is the leading cause of death in 

people with type II diabetes. People with diabetes have 

a greater risk of having a CVD event. The high blood 

sugar in type II diabetes damages blood vessels and 

the nerves that control the heart. Artery walls are 

damaged causing heart failure. [31] 

 
Afflictions of Type II Diabetes 
 

The elderly population with Type II diabetes 

can undertake a lot of disorders. A few conditions that 

develop due to the disease may include eye damage, 

skin conditions, nerve damage, and sleep apnea [32]. 

As blood sugar levels increase, the insulin-producing 

beta cells in the pancreas release more insulin, causing 

cells to become impaired and unable to develop 

enough to meet the body's demands [33]. As a result, 

the risk of receiving eye damage from Type II diabetes 

is elevated.  

 

Blindness is one of the potential long-term 

effects because of damaged blood vessels in the retina 

which can eventually lead to blinding afflictions such 

as cataracts and glaucoma [30]. 

 

Additionally, nerve damage may be caused 

because of high blood sugar. Indication of neuropathy 

could be identified by tingling, numbness, burning, or 

loss of feeling that usually begins at the tips of toes or 

fingers. Elders are usually likely to underestimate the 

damage to their diabetic foot. Involving injuries 

leading to amputations. Generally, the damage spread 

upward throughout one [32]. Nausea, vomiting, 

diarrhea, or constipation are factors that may take 

place. In men, the damage may cause erectile 

dysfunction [34]. Obstructive sleep apnea is a 

frequently common condition in people with Type II 

diabetes [32]. This regard sleeping disorders which 

repeatedly come and go. Snoring loudly and feeling 

intriguingly tired may be signs of sleep apnea.  

 

Diabetics are substantially more prone to this 

because of alterations made in glucose metabolism. 

Though treating this sleeping disorder has been proven 

to also assist in helping your blood sugar levels [35]. 

https://riograndeguardian.com/new-research-shows-economic-power-of-hispanic-households-in-rgv/#:~:text=Between%202010%20and%202019%2C%20the,grew%20to%2091.5%25%20in%202019
https://www.cdc.gov/diabetes/library/features/hispanic-diabetes.html#:~:text=Diabetes%20Affects%20Hispanic%20or%20Latino,it%20at%20a%20younger%20age
https://www.cdc.gov/diabetes/library/features/hispanic-diabetes.html#:~:text=Diabetes%20Affects%20Hispanic%20or%20Latino,it%20at%20a%20younger%20age
https://scholarworks.utrgv.edu/som8127/4/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099963/
https://pubmed.ncbi.nlm.nih.gov/29238004/
https://pubmed.ncbi.nlm.nih.gov/29238004/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166557/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4066461/
https://pubmed.ncbi.nlm.nih.gov/28412095/
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy#:~:text=Diabetic%20retinopathy%20is%20the%20most,more%20likely%20to%20develop%20cataracts.
https://pubmed.ncbi.nlm.nih.gov/29669543/
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
https://medlineplus.gov/ency/article/000305.htm#:~:text=Without%20enough%20insulin%2C%20glucose%20builds,symptoms%20of%20type%201%20diabetes
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/diabetic-retinopathy
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
https://pubmed.ncbi.nlm.nih.gov/22911959/
https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193
https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631#:~:text=Sleep%20apnea%20is%20a%20potentially,occurs%20when%20throat%20muscles%20relax


Aleman, et al. Type 2 Diabetes in Elderly 

  https://doi.org/10.47488/dhrp.v2iS2.66 

 

 
 
 DHR Proceedings ǀ http://dhrproceedings.org  52 2022, Vol. 2 No. S2 49-54 
   

Treatments for Type 2 Diabetes 
 

Treatment for type II diabetes has been 

helpful in many patients. Elderly patients have been 

exposed to a variety of treatment options that are 

continuously being studied. Common non-insulin 

antidiabetic drugs such as, “Biguanides,” 

Sulfonylureas, and Thiazolidinediones, are, however, 

the most cost-effective treatments used on elderly 

patients [36].  

 

Metformin is a significant drug used in the 

treatment of type II diabetes. It is effective in lowering 

blood glucose, increasing insulin sensitivity, and 

reducing cardiovascular and hypoglycemia risk [36]. 

The main use of metformin is that it can treat 

hyperglycemia in type 2 diabetes and the improvement 

of glycemic control [37]. An addition to the 

medication is the importance of activating AMP-

activated protein kinase (AMPK) and interpreting 

hepatic gluconeogenic genes and decreasing the 

development of impaired glucose in patients, with 

metformin, however, it stimulates AMPK which 

signals mediated cancer cell apoptosis, and if the 

metformin isn’t given gluconeogenesis will come into 
lay and suppress AMPK and ATP production for the 

cells which would worsen the type II diabetes [38]. It 

is, however, cautiously used in elderly diabetic 

patients with the concerns of them having lactic 

acidosis, gastrointestinal effects such as nausea, 

vomiting, diarrhea, flatulence, the reduction of calorie 

intake, and extreme weight loss [36]. 

 

Sulfonylureas are a recommended second 

line of treatment, however, it is commonly used as a 

first. Sulfonylureas directly islet B cells to closed 

ATP-sensitive K+ channels and stimulate the secretion 

of insulin [36]. There are more cardiovascular effects 

that come into play when taking sulfonylureas. Even 

though it is a cautious drug that should not be used a 

lot, its medication helps with the treatment of type II 

diabetes [39]. The drug is cost-effective; however, it 

increases higher risks of ischemic stroke, 

cardiovascular death, and all-cause mortality in 

matched cohorts [39]. Although the use of 

sulfonylureas is still common in everyday medicine, 

doctors are cautious when prescribing the medication 

to patients. 

 

Thiazolidinediones is a type of insulin 

sensitizer, including troglitazone, rosiglitazone, and 

pioglitazone. It is a receptor that controls normal 

skeletal muscle and hepatic insulin sensitivity. The 

action of thiazolidinediones is to regulate 

hyperglycemia than sulfonylureas and metformin and 

does not increase the risk of hyperglycemia [36]. The 

three treatments of TZD pioglitazone, rosiglitazone, 

and troglitazone are effective in elderly patients but 

should be used cautiously with some health defects 

occurring when on the medication [36]. Pioglitazone 

is well treated in elderly patients with renal 

impairments and type II diabetes, and it does not cause 

hypoglycemia, however, it should be avoided in 

patients with congestive or class Ⅲ-Ⅳ heart failure. 

Unlike, pioglitazone, rosiglitazone and troglitazone 

are medications for TZD that have been removed from 

any pharmacy market, due to patients increased risk of 

myocardial infarction and idiosyncratic hepatotoxicity 

[36]. 

                                             
Conclusion 

  
Type II diabetes has caused many downfalls 

in the history of humanity, especially for the elderly. 

Almost 30 percent of the United States population 

over the age of 65 have been diagnosed with this type 

II diabetes and as a result, caused harm to the elderly 

patient [40].      

 

Complications in an elderly patient with 

Type II diabetes can be severe especially if they are 

over the age of 65; In some cases, the alarming signs 

can help the patient identify type II diabetes in time so 

that they are able to treat it properly [41]. In some 

cases, it may be difficult to recognize any signs or 

symptoms. This may delay finding excellent and 

helpful treatment in time to treat this type II diabetes 

[14]. 

 

Over the years, research has shown that type 

II diabetes can cause severe harm to a patient and even 

death if not treated with time. Each year the incidence 

keeps rising in the elderly population. For many 

elderly individuals, type II diabetes can be 

manageable. [17]. 

 

This has become an important issue 

particularly in Texas and in the Rio Grande Valley 

because of our Hispanic population and the increased 

number of elderlies with Type II diabetes. 

 

This is why we need more research to be done 

and tailored medical care so that we can be able to get 

better treatment based on the research results. 

 

 

 

 

https://pubmed.ncbi.nlm.nih.gov/25249787/
https://pubmed.ncbi.nlm.nih.gov/25249787/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7552083/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5552828/
https://pubmed.ncbi.nlm.nih.gov/25249787/
https://pubmed.ncbi.nlm.nih.gov/25249787/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783602/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783602/
https://pubmed.ncbi.nlm.nih.gov/25249787/
https://pubmed.ncbi.nlm.nih.gov/25249787/
https://pubmed.ncbi.nlm.nih.gov/25249787/
https://pubmed.ncbi.nlm.nih.gov/30903688/
https://pubmed.ncbi.nlm.nih.gov/25700588/
https://pubmed.ncbi.nlm.nih.gov/28190580/
https://txohc.org/communication/data-dashboard/diabetes/#:~:text=According%20to%20the%20U.S.%20Diabetes,%25%20and%20Wichita%20at%2012.3%25


Aleman, et al. Type 2 Diabetes in Elderly 

  https://doi.org/10.47488/dhrp.v2iS2.66 

 

 
 
 DHR Proceedings ǀ http://dhrproceedings.org  53 2022, Vol. 2 No. S2 49-54 
   

Acknowledgments 

 

Dr. Monica Betancourt-Garcia, MD, Scientific 

Director; Melissa Eddie, MS, Program Manager; 

Xochitl Lopez, BS, Program Coordinator 

 

Funding 

 

Funded by DHR Health Institute for Research & 

Development; DHR Health; Region One ESC 

GEARUP College Ready, Career Set! Region One 

ESC GEARUP College Now, Career Connected and 

Region One ESC PATHS 

 
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