Cleveland Clinic journal of medicine
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The jury is still out on whether a low-carbohydrate, ketosis-inducing diet is an effective and safe adjunctive therapy to insulin in type 1 diabetes. The limited published literature reports an association with weight loss and improved glycemic control and may, over the long-term, lead to reduced macrovascular and microvascular harm. However, the attendant increased risk of dyslipidemia, diabetic ketoacidosis, and hypoglycemia warrant caution, close monitoring of patients who embark on the diet, and further research.
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The impact of COVID-19 varies by age group, and it has become clear that individuals over 65 years are disproportionately impacted by COVID-19 both in terms of severity of illness and mortality. Atypical presentations in older adults may result from pathophysiologic changes during aging and immune dysregulation because of the cumulative impact of chronic comorbidities. Herein we review the different clinical presentations of illness for older adults, the unique challenges faced by this population, and strategies for treatment.