Multidrug-resistant sepsis (MDR) is a pressing concern in intensive care unit (ICU) settings, specifically among geriatric patients who experience age-related immune system changes and comorbidities. The aim of this review is to explore the clinical impact of MDR sepsis in geriatric ICU patients and shed light on healthcare challenges associated with its management. We conducted a comprehensive literature search using the National Center for Biotechnology Information (NCBI) and Google Scholar search engines. Our search incorporated keywords such as “multidrug-resistant sepsis” OR “MDR sepsis”, “geriatric ICU patients” OR “elderly ICU patients”, and “complications”, “healthcare burdens”, “diagnostic challenges”, and “healthcare challenges” associated with MDR sepsis in “ICU patients” and “geriatric/elderly ICU patients”. This review explores the specific risk factors contributing to MDR sepsis, the complexities of diagnostic challenges, and the healthcare burden faced by elderly ICU patients. Notably, the elderly population bears a higher burden of MDR sepsis (57.5%), influenced by various factors, including comorbidities, immunosuppression, age-related immune changes, and resource-limited ICU settings. Furthermore, sepsis imposes a significant economic burden on healthcare systems, with annual costs exceeding $27 billion in the USA. These findings underscore the urgency of addressing MDR sepsis in geriatric ICU patients and the need for tailored interventions to improve outcomes and reduce healthcare costs.

Background: Insulin resistance (IR) and diabetes are common chronic conditions amongst elderly patients, that may lead to increase in abdominal adipose tissue deposits and pancreatic size. Methods: A cross-sectional study was conducted in the geriatric OPD in a tertiary care hospital for a period of six months to correlate fasting C-peptide levels, abdominal adipose tissue thickness, and pancreatic size in poorly controlled diabetic elderly patients. Diabetic elderly patients with HBA1c level >7 % were enrolled with their consent. Body mass index (BMI), fasting C-peptide, abdominal adipose tissue thickness and pancreatic size were measured using standard laboratory techniques. The data obtained were assessed categorically and represented as [n (%)]. T-test was used to compare the two groups (p < 0.05). Results: A total of 101 patients were enrolled. The study results showed no significant correlation between subcutaneous fat and pre-peritoneal fat thickness; and fasting c-peptide levels (p = 0.801, p = 0.316). However, there was a significant correlation between the fasting c-peptide levels and pancreatic size (p = 0.001). It was also observed the study participants had a decreased pancreatic size, with the mean size being 4.837 cm in males, and 4.4418 cm in females. Conclusion: Intra-peritoneal fat thickness and pancreatic size can be used as surrogate marker for IR along with C-peptide. All elderly with uncontrolled type 2 diabetes mellitus behaving like type 1 diabetes mellitus needs further evaluation and pathogenic process must be explored. Sarcopenic obesity evaluation must be a part of uncontrolled type diabetes mellitus management.