BALANCING DIABETES AND AGING… 7 IMPORTANT CONSIDERATIONS FOR SENIORS.

Diabetes is a serious disease that affects people of all ages, requiring careful monitoring of blood sugar, heart health, and long-term diabetes complications. For seniors, however, managing diabetes demands more attention, as the risks for complications are compounded by the body’s aging process.

WHAT IS DIABETES?

Diabetes is a disease that is caused by the pancreas not functioning properly. The pancreas produces insulin, which acts to break down the foods we eat. Diabetes results when the pancreas does not make enough insulin or the insulin isn’t being well utilized. The outcome of elevated blood sugar or glucose leads to damaged arteries and reduced blood flow to the organs they supply.

Type 1 diabetes results when the pancreas stops producing insulin. People with type 1 diabetes are dependent on insulin injections to manage their blood sugar.

In type 2 diabetes, the pancreas is still producing insulin, but it may not be enough or isn’t being used efficiently by the body. It can often be managed by weight loss, exercise, and oral medications.

Prediabetes is when blood sugar levels are higher than normal, but not high enough to be considered diabetes. A healthy diet, weight loss, and regular exercise can help keep pre-diabetes from becoming type 2 diabetes.

MANAGING DIABETES

Depending on the form of diabetes, the type of management varies. Yet the goals are the same: healthy blood sugar levels and reduced risk for complications.

The following considerations are important for everyone with diabetes. However, for older adults with age-related changes, managing diabetes requires heightened attention to these considerations, to minimize complication risk.

1. HAVE REGULAR EYE EXAMINATIONS.

Vision is something that slowly declines with age. Over time, diabetes further compromises eyesight by damaging blood vessels and nerves that supply the body, including the eye. Retinopathy results from changes in the blood vessels in the retina. It is the most common form of blindness. Other eye diseases related to diabetes are glaucoma and cataracts.

Poor or reduced vision can hinder activities of daily living, such as accuracy with medications, and blood glucose monitoring, as well as impacting mobility and increasing the risk of falls. It may also affect one’s ability to navigate the kitchen and prepare healthy meals. A decline in vision can lead to depression and increased social isolation, as hobbies and favorite activities are no longer enjoyable.

The American Diabetes Association (ADA) recommends:

-Adults with type 1 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist within 5 years after the onset of diabetes.

-Patients with type 2 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist at the time of the diabetes diagnosis.

2. MONITOR YOUR BLOOD PRESSURE.

The incidence of high blood pressure increases with age. Over time, high blood sugar levels can also increase blood pressure by damaging artery walls, making them stiff and less elastic. Chronic high blood pressure leads to impaired kidney function, already affected by diabetes.

Older adults with diabetes should have their blood pressure checked regularly. Keeping a log of your blood pressure checks between visits helps your health care provider evaluate the effectiveness of your medications and treatment plan.

The American Heart Association recognizes the following blood pressure categories:

3. KNOW YOUR CHOLESTEROL LEVEL

The risk for developing heart disease increases with age, as arteries become stiffer and less elastic. The heart muscle itself becomes weaker and less efficient.

Older adults with diabetes have an increased risk of developing heart disease due to elevated LDL (“bad”) cholesterol and triglyceride levels seen in diabetes. These fats form plaques that line the artery walls increasing stiffness and limiting blood flow.

Your doctor may prescribe a combination of medications to help improve blood sugar and cholesterol levels to reduce the risk of heart disease. It’s important to work closely with your health care provider to determine your best treatment.

4. TAKE CARE OF YOUR SKIN AND CHECK YOUR FEET DAILY.

Aging skin becomes thinner, drier, and less elastic, leaving it weaker and less able to protect itself from injury. Damage to small blood vessels from chronic high blood glucose compromises blood flow. Without adequate blood flow, breaks in the skin and wounds cannot heal, increasing the chance of infection.

Chronic high blood sugar also causes nerve damage, called diabetic neuropathy resulting in numbness, pain, or weakness in the hands and feet. Some people experience a loss of feeling or a burning sensation in their feet. and may not be aware of a small cut or wound that isn’t healing.

Practicing good skin and foot care helps to avoid small cuts or bruises from developing into non-healing wounds that can lead to amputation. Checking your skin should become a daily routine.

The ADA recommends:

-Wash and dry your feet thoroughly every day. Check for sores, cuts, blisters, redness, or corns.

-Keep toenails trim

-Wear moisture-wicking socks and well-fitting shoes that do not rub your feet

-Avoid scratching dry or itching skin to avoid open cuts that can lead to infection.

-Moisturize dry skin, but avoid moisture between the toes that can promote fungus.

-See a podiatrist and dermatologist regularly

5. MAXIMIZE YOUR OVERALL HEALTH.

The body’s aging immune system weakens its ability to ward off illness and fight infection. Older adults should ask their health care provider about receiving all recommended vaccines to maximize overall health.

The Centers for Disease Control (CDC) recommends the following vaccines for adults:

The Shingles vaccine is suggested for those over 50, and the Pneumonia vaccine for those over 65, to improve immunity and outcomes from these diseases. Flu vaccines should be received by everyone annually, The High-Dose Flu Vaccine offers additional protection for adults over 65.

The Tdap vaccine protects against whooping cough. One dose is recommended for adults if they did not receive one as a child and is suggested for anyone who will be in close contact with a newborn.

The Td vaccine protects against tetanus and Diphtheria. Boosters are recommended every 10 years.

The Covid-19 vaccine is highly advised at this time, as we continue to protect against this virus. It is recommended that most adults also receive a booster. Research is ongoing.

6. EAT A HEALTHY DIET

Aging causes our digestive system to slow down. Changes in the lining of the intestines result in a decreased ability to absorb nutrients. In addition, older adults may not have the desire to eat or have lost interest or the ability to prepare healthy meals.

The Diabetes Plate Method is the simplest way to prepare a healthy meal to help manage blood sugar.

–Fill half the plate with non-starchy vegetables (asparagus, broccoli, cauliflower, carrots, green beans, spinach, brussels sprouts, leafy greens, salad greens, tomatoes, and zucchini squash)

–Fill one quarter with lean protein foods (chicken, turkey, fish, lean beef, lean pork, eggs, low-fat cheese, lentils, edamame, tofu)

-Fill one quarter with complex carbohydrates (whole grain bread, brown rice, fresh fruit, corn, peas, potatoes, acorn squash, butternut squash, black beans, kidney beans, low-fat yogurt, and milk)

-Avoid simple carbohydrates (table sugar, honey, jelly, sweetened beverages, syrup)

-Choose healthy fats (olives, olive oil, avocado, nut butter)

7. SEE YOUR DENTIST REGULARLY.

Changes in the mouth, such as dryness, increased cavities, and gum disease are more prevalent as we age. The lack of saliva prevents bacteria from being removed easily. In addition, people with diabetes have an increased risk for other oral health problems such as ulcers, and infections.

Older adults may have poorly functioning or missing teeth, hindering their ability to chew, eat, or even taste food properly. Missing meals increases the risk of low blood sugar or hypoglycemia.

The ADA recommends dental visits twice a year. Regular visits can help catch early warning signs, and lower the risk of developing oral problems that may lead to diabetes complications.

TO SUM UP…

Understanding diabetes and how to manage it is essential for everyone. Diabetes affects so many areas of the body which are compounded by age- related changes. Managing diabetes requires extra attention by older adults to maximize their health and minimize complications.

If you would like help with preventing or managing diabetes, consider a One-on- one Nutrition Counseling session with one of our experienced registered dietitians or join the Diabetes Prevention Program (DPP) designed to help you make better food choices and decrease your risk for developing diabetes. Additionally, our Diabetes Self-Management Education and Support(DSME) group helps improve your skills for managing blood sugars to reduce your risk of developing diabetes-related complications. Schedule an Appointment Today! (240) 449-3094. Many of our services are covered by insurance.