Resources: Tips for Healthy Aging at Hebrew SeniorLife

How to Treat Diabetes

I'm 70 years old and was recently diagnosed with Type 2 diabetes. At my age, what are the best ways to manage my disease?

While the treatment of any disease should be tailored to a patient's specific medicals needs, the management goals for everyone who has diabetes are the same, regardless of their age--enhancing quality of life and reducing complications.

Diabetes is a chronic disease in which the body does not produce or properly use insulin, a hormone required to convert sugar, starches and other foods into energy needed for daily life. People with diabetes have too much glucose, a form of sugar, in their blood. As a result, they may suffer from a number of symptoms, such as extreme hunger or thirst, frequent urination, fatigue, or vision difficulties, and are at increased risk for heart disease, stroke, kidney disease, and other serious complications.

More than half of the 16 million Americans living with diabetes are over the age of 60. Of those over 65, almost 20 percent have diabetes, mostly Type 2, a form of diabetes most common in people over 40 that is linked to obesity, physical inactivity, and family history of the disease. According to government statistics, older adults with diabetes are two to three times more likely to be hospitalized. Diabetes also increases seniors' risk for age-associated diseases and can decrease life expectancy by 10 to 15 years.

"Because they have few or no symptoms, many people with Type 2 diabetes, however, do not even know they have the disease, so serious complications can be compounded by the lack of treatment for the underlying diabetes," says Robert Schreiber, M.D., physician-in-chief at Hebrew SeniorLife.

A number of factors can make managing diabetes particularly difficult for older adults. Modifying lifestyle factors that can lead to Type 2 diabetes, including obesity, poor diet, and lack of exercise, may be more difficult for seniors. Diabetes can exacerbate medical conditions common to older adults, such as high blood pressure and high cholesterol. Complications can develop more quickly in older adults, who may have more--and more severe--complications than younger patients. Cognitive impairments and decreased physical ability may also make it more difficult to follow a treatment plan.

A number of components go into a successful diabetes self-management program. says Dr. Schreiber, including:

  1. Monitoring blood glucose levels regularly - This helps patients know how much food to eat, how much exercise to get, and how much medication, including insulin, to take, as well as helping them feel more in control of their disease.
  2. Following a well-balanced meal plan - Different foods affect blood glucose levels, so planning meals is important. A dietitian can help create personalized meal plans designed to help control blood glucose levels.
  3. Exercising regularly - 30 minutes of exercise most days of the week can improve blood glucose levels of older adults.
  4. Taking medications as prescribed - Medications, both oral and injectable, are key to controlling diabetes, and they should be taken exactly as they are prescribed by a physician.
  5.  Losing weight - Nearly 90 percent of diabetics are overweight; studies have shown that weight loss is an essential element in controlling blood glucose levels.
  6. Checking feet daily - Diabetic neuropathy (nerve damage) can cause cuts, sores and blisters to go unnoticed. Because they heal more slowly in people with diabetes, the risk of infection is greater.
  7. Visiting your health-care team regularly - Regular visits to a primary care physician and an endocrinologist (a diabetes specialist) can help monitor disease progression and modify disease treatment and management plans. In addition, people with diabetes should see an eye doctor annually and a dentist every six months.

While diabetes is a serious disease if left untreated, people with diabetes can effectively manage their condition by controlling their blood glucose level. In fact, the Diabetes Control and Complications Trial, conducted by the National Institute of Diabetes and Digestive and Kidney Diseases between 1993 and 2003, showed that blood glucose levels as close to normal as possible can slow the onset and progression of eye, kidney and nerve diseases. The study was conducted only with Type 1 diabetics, but the lesson applies to all diabetics: control your blood sugar.

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