The Significance of Diabetes in Seniors

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By Dr. Loy Puckett

Diabetes is a significant medical problem that presents major implications for an individual’s health, and it’s also one of the leading causes of death in the United States. Though individuals of all ages can develop or be born with diabetes, older adults and seniors are among some of the most at-risk populations.

In what follows, we’ll clarify the different types of diabetes. Further, we’ll explore the many risk factors that older adults and seniors experience with diabetes. Finally, we’ll discuss effective treatment and management protocols for seniors with diabetes.

Types of Diabetes

Diabetes is an endocrine condition that affects the way the body processes glucose, an energy substance. Two of the most common types of diabetes are type 1 and type 2.

Type 1 Diabetes

Type 1 diabetes is defined as an autoimmune disorder in which the insulin-producing cells in the pancreas are destroyed by cells of the immune system. This lack of insulin production causes a deficiency in an important hormonal regulator of glucose levels in the body. Type 1 diabetes is the rarer of the two types of diabetes.

Though older adults can possibly develop type 1 diabetes, it is extremely rare. This type of diabetes is most often seen in children and younger adults.

Type 2 Diabetes

Type 2 diabetes is a metabolic condition resulting from resistance to insulin or an inability to create enough insulin to meet the needs for glucose metabolism. Older adults and seniors are at an increased risk of developing type 2 diabetes.

The prevalence of type 2 diabetes increases with age, and it is estimated that 25% of people over the age of 65 have the condition. Several issues contribute to the higher risk of type 2 diabetes in older adults, including a sedentary lifestyle, a diet high in processed and refined foods, and a family history of the condition.

Some of the signs and symptoms of type 2 diabetes include extreme fatigue and lethargy, frequent urination, and blurry vision.

Treatment and Management of Diabetes In Seniors

The management of type 2 diabetes in older adults may differ from that in younger adults due to the presence of comorbidities and the potential for adverse effects of medications. Comorbidities are other medical conditions that an individual may have, in addition to diabetes.

These comorbidities may include hypertension, heart disease, and kidney disease. In older adults, these comorbidities may affect the ability to properly metabolize medications, which can increase the risk of adverse effects of certain diabetic medications.

To address these issues, the American Geriatrics Society recommends a personalized approach to treatment in older adults with type 2 diabetes. This approach takes into consideration the individual’s functional status, comorbidities, and preferences.

The goal of treatment is to achieve and maintain optimal blood sugar control while minimizing the risk of adverse effects and complications.

Monitor for Hypoglycemia

Older adults with type 2 diabetes should also be especially mindful and careful to prevent hypoglycemia. Hypoglycemia occurs when blood sugar levels drop too low and can be a serious complication in the management of diabetes. Older adults may be at an increased risk of hypoglycemia due to the presence of additional medical conditions or based on their use of particular medications. Symptoms of hypoglycemia in older adults may be subtle and may include confusion, dizziness, and fatigue.

To prevent hypoglycemia, older adults with diabetes should regularly monitor their blood sugar levels and adjust their treatment appropriately based on the guidance of a medical professional. It is also important for older adults to have a plan in place for managing hypoglycemic episodes, including having quick-acting glucose available at all times.

The following are two of the most common treatment and management protocols for diabetes in older adults and seniors:

Lifestyle Intervention

Lifestyle modification, including diet and exercise, is the first consideration for treatment of type 2 diabetes in older adults. A healthy diet that is rich in whole foods, such as fruits, vegetables, and whole grains, and low in processed and refined foods can be extremely helpful in achieving good blood sugar control and reducing complications.

The American Diabetes Association recommends at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week for older adults with diabetes.

In a recent study, a lifestyle intervention plan that included diet and exercise was shown to improve health objectives dramatically in seniors.

Medication

Medications may also be used to treat type 2 diabetes in older adults. The choice of medication will depend on the individual’s specific needs and may include metformin, sulfonylureas, thiazolidinediones, DPP-4 inhibitors, GLP-1 receptor agonists, or insulin.

It is important to carefully monitor blood sugar levels when starting a new medication and follow the advice of a medical professional to adjust the treatment as needed to ensure optimal control.

Final Thoughts

The prevalence of diabetes in older adults and seniors is high, and it is important for individuals in this age group to receive appropriate care and treatment to manage the condition and prevent complications.

Lifestyle modification, including diet and exercise, should be the first consideration in treatment for type 2 diabetes in older adults.

 

Dr. Loy Puckett MD Dr. Loy Puckett, MD, (Doctor Loy) is an Emergency Medicine Specialist.

Doctor Loy’s career spans almost 25 years of emergency medicine practice, including 10 years as the Medical Director for Moberly Regional Medical Center Emergency Department.  During this time, he also applied his medical expertise to his own successful business of managing emergency physicians. Read full bio.

Your Kids Wish You’d Get Rid of Some Stuff

Image of a cluttered bookcase.

Your kids probably don’t want this stuff.

I have a lot of stuff.

I love my stuff.

We spend our life gathering and collecting things that make our lives more enjoyable.

My wife and I are both bookaholics.

We’ve stacked every bookshelf in our house two deep with our reading treasures. If I hadn’t fallen in love with my Kindle, we’d probably have stacks of books on the floors to walk around.

And who can throw away those left over bit and pieces from projects long past? You know, little cutoff pieces of wood, that you just know you can use somewhere on a later project. What about all the assorted nails, screws and other hardware thrown in old jars and boxes? That stuff is too good to toss.

There are those old 35mm cameras that started gathering dust about 4 digital cameras ago. They might be collector’s items some day.

It’s hard to imagine not using them or having access to them when you need them. But honestly, when was the last time you needed them? How many of these things have gone unused and unnoticed for a while?

As we get older, we move past the accumulation stage of life and settle into living with what we have. Eventually, what we have may become more than we will ever need again. It might be time to declutter and downsize. The more you hold on to, the more your loved ones will have to deal with. That’s not a very smart move.

Aside from heirlooms and assets of value, our homes are generally filled with things that no longer serve us or we simply don’t need. At some point, it makes sense to clear things out and streamline.

Here are some practical dos and don’ts for decluttering your life to make things easier for your family.

Do- Keep things of value: Your antiques, art, and family heirlooms have value. Don’t discard or give away items that are worth something financially or emotionally.

Do- Sort through closets, drawers, and storage: These spaces tend to become black holes that contain unused and unimportant items. Tackle these spaces and reduce, recycle, and donate items you are no longer using.

Do- Enlist your family’s help: Ask your family to help you determine what is worth keeping and what is worth letting go of. You don’t have to accept every recommendation they have, but their impartial advice might help you decide easier.

Don’t- Wait until you die before you pass things down: If you have items you intend to pass along at your death, do it now! You get the enjoyment of spreading your happiness while you can still see it happen. You also get some things out of your house. You can always go visit your things in their new home.

Don’t- Overthink things: People hold onto things for a lot of weird reasons. Don’t overthink the usefulness of something you haven’t looked for in years. If you aren’t actively using an item, consider getting rid of it.

Don’t- Forget others need donations: Many of the things you aren’t using could benefit someone else. From a homeless shelter to helping a woman back on her feet, your unused items could help give someone else a brand new start. Be willing to donate gently used items to make a difference.

Don’t- Be afraid: Decluttering isn’t about losing your things. It’s about taking responsible action to streamline your life and be aware of how much you own and if it serves you. Don’t be afraid of letting go and clearing up space for easier living and a clutter-free home.

Part of prepping for the later part of life is clearing out the clutter. Making things easier for the people who will have to manage your space for you after you’re gone is kind and responsible. Do your part to declutter and get rid of the items that no longer have value or serve your needs.