diabetes

Guest Blog: How senior citizens can cope with diabetes

Diabetes is a condition that affects how the body uses glucose (sugar), the main source of energy. People with diabetes either do not produce enough insulin (Type 1), or their body does not respond properly to insulin (Type 2). The most common types of diabetes are Type 2 and gestational diabetes, which affects women during pregnancy.

As you age, your body does not respond as well to diabetes medicine. You may find that your blood sugar is harder to control. Sometimes low blood sugar is a problem too because seniors tend to be less active than younger people so they don’t use up all their stored glucose or “sugar.” If you have trouble eating or drinking because of illness or other problems, ask your doctor if you should use a pump with insulin or pills instead of shots every day.”

As you age, your body does not respond as well to diabetes medicine.

As you age, your body does not respond as well to diabetes medicine. There are several reasons for this. The most common is that your kidneys are less efficient at processing the medicine, which can result in higher blood sugar levels than intended.

Another reason could be that there is a change in how well your liver processes the medication. In some cases, it may be necessary to adjust how often or how much you take each day in order for it to work effectively and keep your blood sugar under control.

You may find that your blood sugar is harder to control.

As you age, it’s likely that your body will respond less effectively to insulin. This means that your blood sugar may be harder to control.

You might also find that it’s more difficult for you to recognize the symptoms of low or high blood sugar (hypoglycemia). If these symptoms aren’t treated quickly enough, they could lead to serious complications such as seizures or even death.

If these things happen often enough, or if they cause a lot of discomfort or pain in addition to affecting how well your body works overall (for example: feeling confused), then it might be time for an adjustment in medication or weight loss plan for diabetes so that everything runs smoothly again!

Sometimes low blood sugar is a problem.

Low blood sugar (hypoglycemia) is a problem that can occur if you have diabetes. It happens when your body doesn’t have enough sugar to meet its needs, so it sends signals to your brain that you need more of it.

These symptoms may occur:

  • Sweating or shakiness
  • Dizziness, weakness and fatigue

If you feel these symptoms, eat something sweet like juice or candy right away! It’s important not to ignore these warning signs because they could lead to unconsciousness if ignored for too long.

If you have trouble eating or drinking because of illness or other problems, ask your doctor if you should use a pump with insulin or pills.

If you have trouble eating or drinking because of illness or other problems, ask your doctor if you should use a pump with insulin or pills.

If you are having trouble eating or drinking because of illness or other problems, ask your doctor if you should use a pump with insulin or pills.

Take your diabetes medications as prescribed.

It’s important to take your diabetes medications as prescribed. If you don’t, it can be dangerous for several reasons:

  • Your blood sugar could go up or down, which can make you feel sick and tired.
  • You might get infections because of poor circulation caused by high or low blood sugar levels.
  • If a diabetic gets sick with an illness such as the flu or pneumonia, it may be harder for them to recover because their immune system isn’t working properly due to high or low blood sugar levels that aren’t being properly controlled by medication (or lack thereof).

Eat a healthy diet.

You should also eat a healthy diet. Your doctor can tell you what types of food are best for your diabetes.

  • Eat plenty of vegetables, fruits, whole grains and beans. These foods are low in fat and sugar and high in fiber, which helps keep you full longer so that it’s easier to control how much food you eat at each mealtime. They also contain important vitamins and minerals that help control blood sugar levels in the body. Examples include:
  • Fruit such as apples or oranges; vegetables such as carrots or broccoli; whole grains such as whole wheat breads/cereals (not white bread), oatmeal (not instant packets), brown rice

Work with your doctor to make exercise a regular part of your routine.

Exercise is important for senior citizens, who are more likely to have heart disease or diabetes than younger people. Exercise can lower blood sugar levels and help you live longer.

If you have diabetes, your doctor will recommend that you exercise at least 3 times per week for 30 minutes or more each time. Try to exercise at the same time every day so that it becomes part of your routine–for example, before breakfast or after dinner every evening (or both).

Exercise can be a social activity that brings people together in ways other than just talking about their health problems!

Get tested for high blood sugar if you are experiencing symptoms, such as fatigue and frequent urination.

  • Symptoms of high blood sugar
  • How to test for high blood sugar
  • Frequency of testing

If you are experiencing any of the following symptoms, get tested for high blood sugar:

  • Fatigue and frequent urination are common signs of diabetes. If you have these symptoms, talk to your doctor about getting tested for diabetes.

If you have questions about your diabetes or treatment, talk with your doctor or pharmacist.

  • Don’t be afraid to ask questions. If you are unsure about your diabetes or treatment, talk with your doctor or pharmacist.
  • Don’t be afraid to discuss symptoms with family members and friends. They may be able to help you recognize early signs of problems that could lead to a serious illness or injury if left untreated.
  • Ask for a copy of the results from all tests done during your visit so that they can be reviewed at home by someone who knows how they should look (e.g., doctor).

Senior citizens living with diabetes can lead productive lives if they manage their health properly.

The good news is that there are many ways to manage diabetes as you age, and these strategies can make it easier for seniors to live a full life.

Many seniors find that using insulin pumps or other forms of continuous infusion provides better control than multiple daily injections. Others may benefit from new devices such as closed-loop systems that automatically adjust dosing based on the glucose level in their blood at any given time. These technologies can help prevent dangerous fluctuations in blood sugar levels while also reducing stress on joints and muscles caused by frequent needle sticks.

It’s important to talk with your doctor about what will work best for you–and then stick with whatever plan they recommend!

Don’t let diabetes get in the way of enjoying your retirement!

Don’t let diabetes get in the way of enjoying your retirement!

You can still travel, eat out and exercise. You can do everything you always did and live a long, healthy life.

Conclusion

In conclusion, we hope that you have found this article helpful. Diabetes is a serious condition that can be managed with proper care and treatment. If you are concerned about your own health or the health of someone in your family, make sure to contact a medical professional as soon as possible!

By |2023-05-24T19:06:22-05:00May 25th, 2023|News Posts|Comments Off on Guest Blog: How senior citizens can cope with diabetes

Diabetes Risk Factors and Treatments

Diabetes mellitus type 2

Background

Diabetes mellitus is a common metabolic disorder that affects carbohydrate, lipid, and protein metabolism. It is estimated that about 4.4 to 17.4% percent of adults in the United States have diabetes mellitus (Cory , Ussery-Hall, Griffin-Blake et al., 2010). It is estimated that 11.5 million women and 12.0 million men over the age of 60 have diabetes, but many do not know it. The Indian Health Service reported via the National Diabetes Survey of 2007 that of the 1.4 million Native Americans and Alaska Natives in the United States, 14.2% age 20 years or older have diagnosed diabetes. Rates vary by region, from 6.0% of Alaska Natives to 29.3% of the Native Americans in southern Arizona (CDC, 2007). There are two major types of diabetes, type 1 (T1DM) and type 2 ( T2DM). T1DM is characterized by autoimmune destruction of the insulin-producing beta cells of the pancreas, leading to a deficiency of insulin. New-onset of adult T1DM in older adults rarely happens; however, due to better treatment of T1DM, older adults who have been diagnosed at an earlier age are living longer. About 90% of older adults with diabetes have T2DM, which is often related to obesity. T2DM is characterized by hyperglycemia and insulin resistance; however, impaired insulin secretion may also be present. Diabetes mellitus is a major cause of disability and death in the United States, and is the seventh leading cause of death among older adults.

Risk Factors

The risk of diabetes increases with age (45 years and older). Other risk factors include family history, obesity, race (African Americans, Hispanics, Native Americans, Asian Americans, Pacific Islanders), hypertension, less “good” cholesterol (less than 35 mg/dl), lack of exercise, having a history of delivering large babies (≥9 pounds), personal history of gestational diabetes, and pre-diabetes in men and women (Laberge, Edgren, & Frey, 2011). Type 2 is the most common type in older women (CDC, 2007). The risk of death from DM is significantly higher among older ¬Mexican American, African American, and Native American women when compared to Whites. The Centers for Disease Control CDC (2005) names obesity, weight gain, and physical inactivity as the major risk factors for DM among women.

Diagnosis

The most common presentation for older adults with T1DM is hyperglycemia (high blood sugar). Older adults may not have the classical symptoms such as polydipsia, polyuria, polyphagia, and weight loss. Instead, they may have an atypical presentation (Halter Chang & Halter, et al., 2009). They may first present with falls, urinary incontinence, fatigue, or confusion. Because older adults may have T2DM for years before it is diagnosed, they often have macrovascualar and microvascular complications at the time of diagnosis, so evaluation of these should be considered at that time.

Treatment

Prevention is the best approach to care, which involves identifying those at risk and encouraging lifestyle change. Older adults with diabetes mellitus have a high risk for complications related to macrovascular disease, microvascular disease, and neuropathy. Macrovascular diseases include coronary heart disease, stroke, and peripheral vascular disease, which can lead to amputation. Microvascular diseases are chronic kidney disease, which is the most common cause of end-stage renal disease, and diabetic retinopathy, that which can lead to blindness. Peripheral neuropathy presents as uncomfortable, painful sensations in the legs and feet that are difficult to treat. A lack of sensation may also be present and contribute to the risk of falls. There is no cure for peripheral neuropathy, and it tends to be a complication for which patients experience daily challenges trying to manage the symptoms. A combination of medication to address pain and interventions by a physical therapist seems to be the best current treatment.

Treatment is aimed at helping patients to achieve and maintain glycemic control to decrease risk of complications. The initial treatment approach is to work with the older adult to establish treatment goals aimed at reducing long-term complications. This often requires working within an interprofessional team. Aggressive treatment may be appropriate for most older adults; however the risk of hypoglycemia (low blood sugar) is higher in older adults. Older adults with hypoglycemia may have an atypical presentation with acute onset of confusion, dizziness, and weakness instead of tremors or sweating. The best measure of good blood glucose management and controlled blood sugars is HgbA1c levels (glycosylated hemoglobin). This measure of hemoglobin provides insight into the previous 3 months of blood sugar control. If HgbA1c is elevated, it indicates that the blood sugar has been high over time. For most people, a HgbA1c ≤ 7% indicates optimal glycemic control; however, due to poor health outcomes, for frail older adults or those with a life expectancy ≤ 5 years this may not be the best, and a Hgb A1c of 8% might be more appropriate.

Management is successful when a balance is achieved among exercise, diet, and medications. Medications may be oral hypoglycemics or insulin injection. Insulin injection is used in T1DM and may be prescribed for T2DM because as the person ages, beta-cell function declines. If insulin is needed, it is important to consider if there are visual problems and or hand arthritis that limits the dexterity that is necessary to prepare and inject the medication. For some, a simple regimen, such as premeasured doses and easier injection systems (e.g.,insulin pens with easy-to-set dosages) is the best.

Thorough evaluation of readiness to learn and of the ability of an older person to manage his or her medications must be done. Older adults who need to give themselves insulin injections may experience anxiety about learning this task. Demonstration, repetition, and practice are good techniques for the older age group. Adaptive devices such as magnifiers may help if the syringes are hard to read. A family member should also be taught to give the insulin to provide support and encouragement, although the older adult should be encouraged to remain independent in this skill if possible. Williams and Bond’s (2002) research suggested that programs that promote confidence in self-care abilities are likely to be effective for those with diabetes. A plan for times of sickness and the use of a glucometer to monitor blood sugars will also need to be addressed. Additionally, the dietician may be consulted to provide education for the patient and family on meal planning, calorie counting, carbohydrate counting, and nutrition. Many patients benefit from weight loss, so the nutritionist can assist with dietary planning in this regard also.

Due to the increased risk of infection and slow healing that result from diabetes, foot care is an essential component in teaching older adults to manage DM. Some experts believe that good preventive foot care would significantly reduce the incidence of amputation in the elderly. Older persons with DM should never go barefoot outside. Extremes in temperature should be avoided. Shoes should be well fitting and not rub. Socks should be changed regularly. Elders should be taught to inspect their feet daily, with a mirror if needed. Corns and ingrown toenails should be inspected and treated by a podiatrist, not by the patient. Older persons should see their podiatrist for a foot inspection at least yearly. Patients should be cautioned that even the smallest foot injury, such as a thorn or blister, can go unnoticed and unfelt—and often results in partial amputations that lead to a cascade of lower extremity problems.

For more information on living with Diabetes, visit the American Diabetes Association:
http://www.diabetes.org

 

Adapted from Mauk, K. L., Hanson, P., & Hain, D. (2014). Review of the management of common illnesses, diseases, or health conditions. In K. L.
Mauk’s (Ed.) Gerontological Nursing: Competencies for Care. Sudbury, MA: Jones and Bartlett Publishers. Used with permission.

By |2023-03-01T16:01:15-05:00March 26th, 2023|Dr. Mauk's Boomer Blog, News Posts|Comments Off on Diabetes Risk Factors and Treatments