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Diabetes In The Elderly

Updated: Jul 13, 2023

tools for taking care of elderly diabetes

Diabetes Alert Day is observed annually on the fourth Tuesday in March. It is meant to bring awareness to the seriousness and health implications that come with a Diabetes diagnosis. Diabetes is a chronic medical condition that affects people of all ages, but it is particularly prevalent in older adults. In fact, according to the Centers for Disease Control and Prevention (CDC), more than 25% of adults aged 65 and older in the United States have diabetes. With an aging population and increasing rates of diabetes, it is important to understand how diabetes affects older adults and how to manage it effectively.

Diabetes is a condition that affects the body's ability to use glucose, or blood sugar, for energy. There are two main types of diabetes: type 1 and type 2. Type 1 diabetes is an autoimmune disease that usually develops in childhood or adolescence and requires insulin injections for management. Type 2 diabetes, on the other hand, is more common and is often diagnosed later in life. It is caused by a combination of genetic and lifestyle factors, such as being overweight or obese, being physically inactive, and having a diet high in sugar and refined carbohydrates.

Dr. Medha Munshi, director of the geriatrics program at the Joslin Diabetes Center in Boston works with seniors and their families to help them to understand and treat Type 2 diabetes in a way that allows them to continue to enjoy a functioning lifestyle. “Sometimes the quality of life is more important than achieving a certain number.”

image of an older woman, she has elderly diabetes

Managing diabetes in the elderly is complex as they often have several chronic conditions that require medications, making it challenging to control blood sugar levels. Additionally, treating diabetes too aggressively can make seniors more prone to hypoglycemia or low blood sugar, which can be more dangerous than high blood glucose readings.

This is especially true for frail older people with multiple conditions who are at higher risk of falls and fractures.

Diabetes in the Elderly

Older adults are more likely to develop type 2 diabetes due to the natural aging process and the accumulation of risk factors over time. The aging process affects the body's ability to produce insulin and use glucose, and older adults are more likely to have other health conditions that increase the risk of diabetes, such as high blood pressure and high cholesterol. Additionally, older adults may have more difficulty managing diabetes due to cognitive and physical limitations, such as memory impairment, mobility issues, and vision problems.

Diabetics over 65 are more likely to have complications like heart attacks, kidney disease, and blindness.

Complications of Diabetes in the Elderly: Diabetes can have serious complications if left unmanaged, particularly in older adults.

These complications include:

  • Cardiovascular disease: Diabetes increases the risk of heart attack and stroke, and older adults with diabetes are at even greater risk due to age-related changes in the heart and blood vessels.

  • Neuropathy: Diabetes can cause nerve damage, leading to pain, numbness, and tingling in the hands and feet. This can be especially dangerous in older adults who may have reduced sensation and an increased risk of falls.

  • Retinopathy: Diabetes can damage the blood vessels in the eyes, leading to vision loss and blindness. Older adults are already at increased risk of age-related vision problems, and diabetes can exacerbate these issues.

  • Kidney disease: Diabetes can damage the kidneys, leading to kidney failure and the need for dialysis or kidney transplant. Older adults may already have reduced kidney function due to aging, making them more susceptible to kidney damage from diabetes.

Those over the age of 65 with diabetes are more likely to end up in nursing homes than other seniors.

Managing Diabetes in the Elderly: Managing diabetes in older adults requires a multidisciplinary approach, involving healthcare providers, family members, and individuals with diabetes themselves. The goals of diabetes management in the elderly are to maintain blood sugar levels within a healthy range, prevent complications, and maintain quality of life.

Here are some tips for managing diabetes in the elderly:

  • Regular medical check-ups: Older adults with diabetes should have regular check-ups with their healthcare provider to monitor blood sugar levels, blood pressure, cholesterol, and other health parameters.

  • Medication management: The aged population will often be on a regimen of various prescriptions to treat health conditions in addition to type two diabetes which if not monitored closely has the potential to create drug interactions and negative side effects. Most geriatric healthcare providers work together with patients to manage medications and ensure they are safe and effective with limited interaction and adverse effects.

  • Lifestyle modifications: Lifestyle modifications, such as eating a healthy diet, getting regular exercise, and managing stress, can help improve blood sugar control and prevent complications of diabetes.

  • Exercise is important, but older people may have trouble getting outside or to a gym and may be afraid of falling. Dr. Munshi said, "They think they have to walk fast for 30 minutes." She tells them to start by taking five minutes to walk around their homes before each meal.

  • Geriatric medicine is about finding a balance and making concessions. "It might not be the best way to treat diabetes, but it's the best way to treat the patient," she said.

  • Social support: Social support from family members, friends, and support groups can be helpful in managing diabetes and maintaining the quality of life.

  • Preventative care: Older adults with diabetes should receive regular eye exams, foot exams, and kidney function tests to prevent and manage complications.

Diabetes has its own complications, but in the elderly, treating the patient is more important than the diagnosis. Diabetes rarely occurs alone in people over 70. Dr. Medha Munshi, director of Boston's Joslin Diabetes Center's geriatrics program, advises her patient's loved ones to take care but not become obsessed with the numbers. Most elderly diabetics have multiple chronic conditions and medications. This makes blood sugar control difficult. Cognitive problems, depression, and worsening eyesight can make diabetes routines harder. Dr. Munshi works to treat the patient and not the diagnosis.

image of Blakey Hall, people with elderly diabetes live there

At Blakey Hall, we work with our medical experts, nutritionist, and residents to keep their numbers in check when it comes to their diabetes. If you have a loved one that struggles with routines and keeping their numbers in check and you are considering if assisted living might be a good fit, reach out to schedule a tour of our facility today.

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