Intravenous fluid therapy and heart failure in uncontrolled diabetes of the elderly

Fluid balance and the prevalence of heart failure have been analysed in a group of patients over 75 years of age, and a group of patients under 40 years of age presenting with severely uncontrolled diabetes. Though the total volume of fluid given was significantly lower in the elderly, the net retention of fluid was similar in the two groups, implying a smaller urine output in the elderly. Despite the lower volume of fluid given, signs of heart failure were detected in 17 of 44 episodes (39%) in the elderly compared to only 1 of 50 episodes in the young. Even greater caution is required with fluid replacement in elderly patients with uncontrolled diabetes.