What is a major health concern for older adults with type 2 diabetes and a history of heart disease?

The major health concern for older adults with type 2 diabetes and a history of heart disease is hyperosmolar hyperglycemic syndrome (HHS). This condition is characterized by extremely high blood glucose levels, leading to severe dehydration and significant metabolic disturbances. Older adults, particularly those with diabetes and cardiovascular issues, may have impaired kidney function and a decreased physiological response to dehydration, making them more susceptible to HHS.

Hyperosmolar hyperglycemic syndrome often occurs in situations of stress or illness where there is insufficient insulin present, causing glucose levels to rise significantly. The combination of diabetes and heart disease can also complicate the management of glucose levels, increasing the likelihood of this condition developing during acute illnesses or in response to medications that can affect fluid balance.

In contrast, while infections can be a concern for older adults with diabetes, especially given the potential for compromised immune function, it is not as acute a priority as monitoring for HHS. Rapid weight loss may occur in diabetic patients but is not specifically tied to the combination of age, type 2 diabetes, and heart disease in the same critical manner as HHS. Improved wound healing is generally not a major concern; rather, poor wound healing is common among diabetic patients, particularly in older adults. Therefore