November 23, 2013

By Diane Walker, RN, MS, CSA

Diabetes is on the rise in the United States in general, but adults over the age of sixty-five are more likely to develop diabetes than any other age group. Due to this fact, it is important to understand the symptoms and have a care plan in place in case an older adult in your life is diagnosed with diabetes.

Diabetes is not a disease to be taken lightly. It can be life threatening if uncontrolled. Unfortunately, as a person ages, insulin resistance can increase while the pancreatic islet cell function decreases. This can put an older person at a greater risk for Type 2 diabetes. When the body is unable to control its insulin levels, diabetes occurs.

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Why Does Diabetes Occur?

Insulin is produced in the pancreas by beta cells and is crucial to the body’s ability to metabolize fat and regulate carbohydrates, as well as the ability to absorb glucose from the blood. When blood glucose levels fall below a specific level, the body begins to break down glycogen stored in the muscles and liver into glucose — this process known as glycogenolysis transforms glucose into an energy source and is used to send functionality signals to other systems within the body.

Type 2 diabetes occurs when a person’s body pushes blood glucose – sugar – to above normal levels. When this happens, the pancreas compensates by making additional insulin to offset the higher glucose level. This works for a while, but a point comes when the pancreas can no longer make enough insulin to keep blood glucose levels at normal. This is when medications and insulin may be prescribed by a doctor.

Prevention & Care Plan

Type 2 diabetes can be prevented. There are many factors that contribute to preventing the onset of diabetes. To help keep the disease at bay, monitor your blood sugar, blood pressure, and cholesterol levels. Adopting a healthy diet, staying active, and maintaining healthy weight for your age and height may also help stave off a diabetes diagnosis.

Many of the factors that can help prevent diabetes are also instrumental in managing diabetes if you do have it. Starting to adopt healthier practices sooner rather than later may help prevent development of the disease to begin with.

If you do have Type 2 diabetes, however, controlling your blood sugar levels is quite important – when uncontrolled it can lead to other serious and even life-threatening illnesses. Diabetes has been found to be a factor in heart disease, stroke, kidney disease, and visual impairment. In addition, poor circulation, due to diabetes, in one’s extremities – especially the feet and legs – prevents wounds from healing and can lead to amputations. Adding to these complications, in older adults, you might also see depression, vision problems, falling, urinary tract infections and incontinence, and memory issues.

To decrease complications and live a healthy life following a diabetes diagnosis, it is imperative to have a diabetes care plan. The plan should include the following:

Proper Diet
For most adults who develop diabetes, it is necessary to make important changes to your diet that will help control blood sugar levels. Typically, limiting carbohydrates is the first step. A nutritionist should be assigned to the older adult by their primary care physician. With the help of the nutritionist, a daily diet plan can be put into place.

As everyone knows, exercise is part of any healthy lifestyle. For older adults, if possible, walking is a great exercise. It can also help decrease blood sugar levels which, in turn, may decrease the need for medications and insulin. Do check with a primary care doctor before making any changes in medications.

Not only is it important to take the medication prescribed, it is also important to take it at the right time of day. It can be difficult for the older adult or their family member to give the patient insulin shots. It takes getting used to. Take advantage of insulin assistance programs in your area. They can provide training and support as needed. It is critical that medications and insulin are taken at the proper time of day and in the proper amounts; otherwise, blood sugar levels can rise and fall leading to dizziness, falls, and even comas.

Minimizing Risks
While diabetes comes with many possible complications, they can be minimized. It is important to have the older adult’s eyes checked on a yearly basis. Also, make sure that their primary care physician checks their feet for circulation on each visit as well as being on the lookout for sores that do not heal.

Those with diabetes are susceptible to osteomyelitis. This is when a foot infection goes into the bone and may require amputation if antibiotics fail. Getting proper medical attention as early as possible can make a tremendous difference in the quality of life.

Making Sure Your Care Plan Is Working

One way to be sure your care plan is working is to take the A1C test at least twice a year. This blood test is typically administered by doctors and used to diagnose diabetes, as well as measure how well a person is managing his or her diabetes and whether your treatment plan is working. The test shows a person’s average blood glucose control over the previous 2 to 3 months. It shows “the big picture” as to how adhering to a treatment plan helps, whether that treatment plan is working, and also confirming the results of regular tests, whether they are self-administered or performed by a doctor.

While diabetes is a chronic condition that must be controlled for life, with proper care and support, the older diabetic adult can achieve a healthy, normal life with a little help from their family and caregivers.