Diabetes affects more than 25 percent of the adult population aged 65 and above in the U.S. The burden of living with diabetes is usually measured in terms of how it impacts those people of working-age.
Diabetes among older adults has been linked to a higher mortality rate. This condition is also linked to increased risk of institutionalization and decreased functional status. Older adults with this condition are also at risk of cardiovascular and microvascular illnesses.
Type 2 Diabetes is most prevalent in older adults. One reason why older adults develop type 2 diabetes is because of the decline in their pancreatic islet function.
This impaired pancreatic function is also coupled with increased insulin resistance as they age.
Insulin resistance occurs as a result of a lack of physical activity, sarcopenia, and adiposity in seniors.
If You Suspect You Might Have Diabetes, Get Tested
Call your doctor if you are concerned that you may have Diabetes.
There are also diabetes home tests you can use to help determine your risk of diabetes (pre-diabetes) or how well your diabetes is being managed.
If you’d like to be tested at home, a home diabetes test for HbA1c can help identify pre-diabetes. It can also help you see how well a person’s diabetes is being controlled after a positive diagnosis.
A high HbA1c result means that you have too much sugar in your blood. HbA1c or glycated hemoglobin is made when glucose (sugar) in your body sticks to your red blood cells.
If your body can’t use sugar properly, more of it sticks to your blood cells and builds up in your blood.
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Common Complications of Diabetes in the Elderly
In some cases, the symptoms of diabetes are not so obvious. Many seniors think that frequent urination is a normal part of aging, but it can be a symptom of diabetes.
Other symptoms such as excessive thirst and lethargy are also mistaken as “normal” for aging people. In turn, a lot of seniors go undiagnosed for diabetes for several years.
Sometimes, it is only when they experience kidney or artery damage that they finally get diagnosed for diabetes. But, once a diagnosis is made, it is a must for it to be managed well. Otherwise, one will face a higher risk of suffering from diabetes complications such as the following:
Hearing Problems
Hearing problems are common among aged people. But, those who have diabetes are two times more at risk of having impaired hearing.
To date, there isn’t any cure for hearing loss. Luckily, hearing aids are available for those who have issues with hearing.
If you have problems hearing other people talk, consult your doctor. Others do not realize that their hearing ability is declining. Sometimes, it is only when other people notice that your TV has a very high volume that they start to suspect you’ve got hearing problems.
Vision Problems
With aging comes declining vision. However, for diabetics, vision loss is often accompanied by constriction of blood vessels. Add in the tendency to have high blood pressure, which also harms their ability to see clearly.
Laser treatment is now available for sufferers of diabetic retinopathy. But, the importance of long-term management of blood sugar cannot be overemphasized.
Managing blood suer levels is a must in order to avoid the recurrence of diabetic retinopathy after its successful treatment.
If diabetic retinopathy is left untreated, it can also lead to diabetic macular edema or DME. Besides, people with diabetes are up to five times more likely to develop cataracts. They are also almost twice as likely to have glaucoma.
Cognition and Memory Problems
People with diabetes are often found to have deposited plaques in the brain. This hinders proper impulse transmission. Not to mention the problems it can cause with one’s cognition and memory.
Mood problems will also tend to become worse among aging diabetics. Studies have shown that diabetes increases one’s risk for cognitive impairment.
Results from repeated neuropsychological tests confirmed the link between diabetes and cognitive decline. Five out of seven studies also showed that people with diabetes are almost twice as likely to suffer from dementia.
A problem with diabetics is that their cognitive abilities must be functioning at its best at all times. Better management of diabetes will not be possible when one has declining cognitive skills. This is why diabetics need to have the assistance of a caregiver or their loved ones as they age.
Bone And Joint Problems
Diabetes worsens joint and bone problems that occur with aging. The risk of bone and joint problems increases as they gain weight and grow older. These problems are compounded by neuropathy that is common in diabetics.
Neuropathy is a condition characterized by nerve damage in the extremities. Some of the symptoms of neuropathy are tingling sensations and pain in the arms, hands, legs, and feet.
When nerves become damaged due to chronic high blood glucose levels, charcot joints may also develop. This condition usually affects the feet and is also referred to as neuropathic arthropathy.
Nerve Damage
If diabetes is left untreated, it can also cause nerve damage. This will then lead to diabetic neuropathy and eventually to amputation.
Diabetic neuropathy is characterized by tingling and numbness of the hands, feet, fingers, and toes. It can also cause sharp, burning pains that make it hard for them to sleep well.
Up to fifty percent of diabetics claim to have nerve pain. Moreover, older adults were found to have the highest rates of leg amputation due to diabetes.
Heart Disease and Stroke
If diabetes is not managed well, can lead to heart disease. Coronary heart disease is a common cause of death among 80 percent of diabetics.
Having hyperglycemia or high blood glucose levels can lead to adverse changes in the blood vessel makeup. The blood vessel linings will become thicker. The thickening of the blood vessel lining will then result in reduced blood flow. This increases one’s risk of cardiovascular disease, heart attack, and stroke.
The diabetes treatment plan for seniors is not a one-size-fits-all approach. Each treatment plan differs from one senior to another. But, the overall goal should always be to reduce the risk of complications. Work with your doctor to gain better control of your blood glucose. This is important to avoid any complications.
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Diabetes Self-Management Tips
Track your blood sugar.
Do this by creating a blood sugar log. This can be done through the “memory” feature on your meter.
You can also download a diabetes app using your smartphone.
Older adults diagnosed with diabetes are at risk of hypoglycemia. Symptoms of hypoglycemia include dizziness, confusion, sweating, and hunger.
If hypoglycemia strikes, eat 10 to 20 grams of sugar. You may also take one teaspoon of honey, five crackers, or one-half cup of soda. After fifteen minutes, check the blood sugar level once again. If it is too low still, repeat the process. If blood glucose does not improve, seek medical attention.
Know how to eat right.
Do this by learning how to read food labels. Also, be conscious of your portion sizes in every meal. Your carb intake must not be more than the size of your fist. The same is true with fruits and grains.
Consume meat that is only as big as your palm and as thick as your little finger. Fat and oil consumption must also be limited. It should not be more than the size of the tip of your thumb.
Make sure you are also aware of how each food affects your blood sugar levels. Most of all, know which foods to choose that will help you better manage your diabetes.
If possible, consult with a nutritionist. This will help ensure you are eating the right foods at the right time and the right amount.
Get moving.
You must be aware of how exercise affects your blood sugar and insulin levels. Swimming, bicycling, and walking are aerobic exercises that are good for people with diabetes. It helps them keep their blood glucose under control. It also prevents them from becoming overweight or obese.
The American Diabetes Association advises that people with diabetes must spend at least 30 minutes of exercise every day. Do this for at least five days a week.
If you find it hard to exercise for straight 30 minutes, split it up into 10 minutes of exercise three times a day. It is also helpful if you engage in resistance training.
Make use of resistance bands or free weights. This kind of training helps you build muscles and keep your blood glucose under control.
Physical activity is a crucial part of your diabetes management plan. Consult a fitness expert before starting any exercise program to ensure that you are doing everything right. Remember that several factors need to be considered in your fitness program.
Never skip a medication.
Older adults have a high tendency to forget their medication. This may not come as a surprise since forgetfulness is common in the aged population.
Make use of pill organizers. Luckily, there is an app for that! Download it on your smartphone or tablet. You can also buy a pillbox, so it is easy for you to see which pill to take.
Things that Must be Included in Your Diabetes Care Plan
- You must get an annual retinal image exam. Poor eyesight will make it hard for you to monitor your blood glucose. Injecting insulin is also tricky with poor vision.
- Have your kidneys checked every year.
- Blood and urine tests must be conducted annually. o check whether diabetes is harming your kidneys or not.
- Know your blood pressure level. Knowing your blood pressure is just as important as knowing your blood sugar level. Visit your local pharmacy or senior citizen center for a free blood pressure check.
- Your cholesterol levels must also be checked every six months to a year.
- If possible, consult a dietitian so you will know how to obtain good fats and steer clear from bad fats in your diet.
- Check your A1C levels every three to six months. This A1C test checks your average blood glucose level for the past three months. The result of this test is essential for your diabetes treatment plan.
- Pay attention to your skin. Always check for the presence of cuts or wounds. Consult your doctor if there is a non-healing wound or unusual skin problem.
- Check your feet every day. See to it that it does not have any blisters, cuts, or fungal infection. Moisturize it with alcohol-free lotion. But, never apply the lotion in between your toes. Know the proper way to trim your toenails. Cut it straight across to prevent ingrown nails.
- Get checked for periodontal disease every six months. Gum problems characterize this condition. People with diabetes are at risk of having periodontal disease. Poor management of blood glucose causes damage not only to the nerves. It can also damage your blood vessels and gums.
- Get vaccinated for flu and pneumonia. People diagnosed with diabetes should have flu vaccines every year. They also need to have a pneumonia vaccine before they reach 65 years old. Others are required to get a booster after five years.
A Caregiver’s Guide to Caring for an Elderly with Diabetes
Regular doctor visits.
See to it that your parent visits her doctor regularly. She must be aware of the dos and don’ts of diabetes management. Make sure that they understand the importance of having regular checkups for blood sugar, blood pressure, eye and gum health, etc.
Build your own network of support.
Make friends with dietitians who can give you helpful suggestions for your parent’s daily meals. A pharmacist will also be of big help, especially if your parent needs to take several medicines in a day.
Make sure you also have friends who can readily provide you with assistance whenever you need it. Having these people in your network will make caregiving a lot easier.
Be a well-informed caregiver.
You should understand the symptoms of hypoglycemia and hyperglycemia. Learn how to provide first-aid care in cases of hypoglycemia or hyperglycemia attack.
Make sure the elderly are eating the right kind of diet.
Strict adherence to a diabetes diet is crucial in a diabetes management plan.
Ensure that meals are ready when needed. Pre-cooked meals and snacks are beneficial. Even if you are away, your parents will not be at risk of missing a meal.
It is also a good idea to enroll him in programs like Meals on Wheels.
Encourage the elderly to get moving.
Make him understand the benefits of resistance training or aerobics in managing his blood sugar levels. There are also senior centers that offer opportunities for physical activities appropriate to their age.
Offer help in feet checking.
If your parent finds it hard to check his feet every day, offer help. Spend a few minutes checking both feet for cracks, cuts, or ingrown toenails.
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Resist the urge to treat your parent like a child.
The two of you must work as a team. Encourage the elderly to be in charge of his health. But, let him know that you are always there to assist whenever he needs it.