Diabetes in Older Adults/Seniors

Diabetes is a serious disease that affects a large number of older adults. Diabetes is caused by high blood glucose levels, also known as high blood sugar. Type 2 diabetes is the most common type of the disease in older adults. Fortunately, you can take steps to delay or prevent this condition. Diabetes is a serious health condition that can cause serious complications. However, there are steps you can take to prevent diabetes-related health problems.

What is Diabetes?

Many of the foods we consume are converted into sugar, or glucose, by our bodies, which gives us energy. For glucose to be used as energy, our body needs insulin, a hormone that helps glucose enter our cells. A diabetic's body may not be producing enough insulin, may not be using insulin correctly, or both. Over time, that can cause too much glucose to remain in the blood, which may lead to health problems. Depending on your condition, your family doctor might refer you to an endocrinologist who specializes in treating people with diabetes. Diabetes is often managed directly by your family doctor.

Diabetes and COVID-19

Older adults with type 1 or type 2 diabetes can be more at risk of becoming severely ill from COVID-19, a respiratory disease that is more serious than the flu. It is very important to take precautions to avoid infections when dealing with this virus. If you feel that you have been exposed to COVID-19, it is important to talk to your health care provider about the symptoms you are feeling. To learn more on how COVID-19 impacts people with diabetes, visit the CDC.

Types of diabetes

Diabetes has two forms: non-insulin-dependent and insulin-dependent.

  • If you have Type 1 diabetes, the body does not make insulin. It is more common in children and young adults, but older adults can also develop this type of diabetes. Individuals who develop it have it for life.

  • Type 2 diabetes occurs when the body cannot produce or use insulin properly. Diabetics with this condition are most common. Most commonly, this disease affects adults in their middle and old age, but it can also affect children. Inactivity, overweight, and family history of diabetes all increase the likelihood of getting type 2 diabetes. Diabetes type 2 (the type that occurs later in life) is more likely to develop in women with a history of gestational diabetes (a type of diabetes that occurs during pregnancy).

Various parts of the body can be affected by diabetes. Diabetes needs to be managed because, over time, it can cause serious health problems like heart disease, strokes, kidney disease, eye problems, and nerve damage that may lead to amputation. In addition, type 2 diabetics may have a higher risk of Alzheimer's disease and cancer.

Is prediabetes the same as diabetes?

Prediabetes is a condition in which blood glucose levels exceed normal, but not high enough to be called diabetes. Diabetes type 2 and heart attacks or strokes are more likely to be developed in people with prediabetes.

In the event that you have prediabetes, there are steps you can take to avoid or delay type 2 diabetes. One option is to lose weight. Being physically active and eating healthy can make a significant difference, too. Get in touch with your doctor to discuss making healthier food choices and exercising more regularly. It is important to quit smoking (if you smoke), because smokers have a higher risk of developing type 2 diabetes than nonsmokers. You should speak with your physician about how often your glucose levels need to be monitored. There is also a possibility that your doctor will suggest that you take medication to delay or prevent type 2 diabetes.

Symptoms of type 2 diabetes

You may feel tired, feel hungrier or thirstier, lose weight without trying, urinate frequently, or experience blurred vision if you suffer from type 2 diabetes. Skin infections and slow healing from cuts and bruises are also possible symptoms. The symptoms of type 2 diabetes often develop slowly and go unnoticed, so some people may not know they suffer from it. Symptoms of aging may be dismissed by older adults as "getting old," but they can indicate serious problems as well. Consult your doctor if you experience any of these symptoms.

Tests for diabetes

Diabetes can be diagnosed by several blood tests, including:

  • Blood glucose test - done at any time of the day

  • Testing your A1C can be done any time of the day; it provides your average glucose level of the past three months

  • A fasting plasma glucose test is conducted after you have not eaten for at least eight hours

  • Oral glucose tolerance test - taken after fasting overnight, and then again after drinking a sugary drink (this is not routinely done for type 2 diabetes).

Before a diagnosis of diabetes is made, your doctor may want to test you twice.

Type 2 diabetes management

It is possible to control blood glucose levels by diet and exercise alone for many people with type 2 diabetes. Other patients may need to take diabetes pills or insulin injections, as well as medicines to manage conditions like high blood pressure and high cholesterol. Diabetes patients may need both lifestyle changes and medication over the course of time.

Your healthcare team will work with you once you've been diagnosed with diabetes to develop a diabetes management plan. Plans are individualized based on each person's lifestyle, preferences, health goals, and other health conditions. If necessary, your physician may prescribe a medication. You may also need the assistance of other health care professionals. If you would like help understanding diabetes and managing your diabetes, a diabetes educator may be able to provide you with support. A dietitian may be able to assist you in meal planning. If you want to become more physically active, you might want to see an exercise coach.

Diabetes and brain health
If you have diabetes, your doctor may screen you for depression or cognitive impairment. Older adults with diabetes are at higher risk for these conditions, compared with others their age who do not have diabetes. Having depression or cognitive impairment can make diabetes self-care challenging.

As part of your diabetes management plan, you will learn how to:

  • Measure your blood glucose levels. If your glucose levels are very high (called hyperglycemia) or very low (called hypoglycemia), it can be dangerous to your health. Checking your glucose and getting the A1C test will be in your plan. If you are managing your diabetes without taking insulin, you may not need to check your glucose as often.

  • Eat healthy foods. You should learn what to eat, how much, and when is best for you so you can manage your glucose levels. Working with your doctor to develop a weight loss plan is a good idea if you are overweight.

  • Be active. Walking and other forms of daily exercise can help improve glucose levels in older people with diabetes. Set a goal to be more active most days of the week, and exercise, including daily walks, can help people with diabetes improve their glucose levels. Create a plan for being physically active that fits into your life and that you can follow. Your health care team can help.

  • Take your medicines. It is important to take medications even when you feel well. Do not hesitate to tell your doctor if you have any side effects or cannot afford your medications. Please let your doctor know if you have difficulty taking or keeping track of your medication.

Here are some ways to stay healthy with diabetes:

  • Manage your blood pressure. Get your blood pressure checked often.

  • Manage your cholesterol. At least once a year, get a blood test to check your cholesterol and triglyceride levels. High levels may increase your risk for heart problems.

  • Stop smoking. Smoking raises your risk for many health problems, including heart attack and stroke.

  • Have yearly eye exams. Finding and treating eye problems early may keep your eyes healthy.

  • Check your kidneys yearly. Diabetes can affect your kidneys. Urine and blood tests will show if your kidneys are okay.

  • Get flu shots every year and the pneumonia vaccine. You may keep yourself healthy by taking an annual flu shot. Get vaccinated against pneumonia if you're over 65. You might need another pneumonia vaccine if you were younger than 65 when you received it. Speak to your doctor about this.

  • Care for your teeth and gums. Brush and floss your teeth every day. You should visit your dentist twice a year to ensure good oral health.

  • Protect your skin. Use moisturizers to keep your skin soft. Clean up minor cuts and bruises as soon as possible to prevent infections.

  • Look at your feet. Check for red patches on your feet every day. If you can't, have someone else check your feet for you. You should consult a foot doctor, called a podiatrist, if you have blisters, breaks in your skin, and infections.

  • Keep up with cancer screenings. Ask your doctor which screenings to get based on your age, gender, and other risk factors.

  • Talk with your doctor about your concerns. If you think you might need help with your management plan, are depressed, are worried about your memory, or have any other concerns, talk with your doctor. There may be ways to help.

You should have your health care team evaluate your diabetes management at least once a year. You might need to make changes to your management plan, or you might need more information and support. Changing your diabetes management plan may also be prompted by changes in your health, such as a new diagnosis or complication, or a change in your care, such as going home from the hospital.

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