Controlling high blood sugar in elderly

Patient : I am 88 years old with type2 Diabetes a bad back and find it difficult to exercise. I currently take Januvia and Insulin my sugar is still high.Any suggestions.
Doctor :   Because of the normal physiological changes associated with aging it makes the recognition and treatment of diabetes dif ficult in the elder patients. Alterations in carbohydrate metabolism, changes in the pharmacokinetics (drug absorption, distribution, metabolism, and clearance) of both insulin and oral medications must be considered. Also insulin secretion appears to decrease with age, with increase in glucose intolerance and insulin resistance than young individuals. Thus, there is an interplay between decreased insulin secretion and increased insulin resistance that largely explains the abnormal glucose metabolism seen in elderly. Management of diabetes involves an assessment of the overall health condition and a treatment plan worked out to suit your needs and quality lifestyle.  

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