Obesity and nutrition in elderly diabetic patients.

Obesity and lipid abnormalities are powerful independent predictors of both diabetes and cardiovascular disease. Nutrition affects the rate of atherogenesis in elderly patients with diabetes. Excess calories worsen glucose tolerance; recent studies relate dietary fats both to serum cholesterol levels within populations and to the development of coronary disease. Dietary and drug interventions for hypercholesterolemia have been found to reduce coronary disease rates. Some nutrients also elevate blood pressure, which further accelerates diabetic atherogenesis. For elderly diabetic patients who are at high risk of atherosclerotic cardiovascular disease, control of diabetes should include--in addition to normalization of blood sugar levels--correction of blood lipids and control of weight and blood pressure.