The Toughest Challenges for Diabetic Seniors

Type 2 Diabetes is one of the most significant and ever-growing diseases in the United States as the 7th leading cause of death. Also termed Adult-Onset Diabetes, T2D occurs when the body can no longer effectively make or use the insulin it produces, resulting in too much glucose (sugar) circulating in the bloodstream. While strict glucose control can delay the progression of complications, a healthy diet and regular physical activity are also necessary.

However, those diagnosed with T2D late in life may find it difficult to navigate effective lifestyle changes. In the past few decades, confirmed diagnoses have increased dramatically in adults over the age of 65. Special attention is needed for both the clinical and functional characteristics of seniors with type 2 diabetes. Most of this population have at least one concurrent condition along with their diabetes, along with risks for several types of impairments or disabilities. 

Although prevention of type 2 diabetes is the ultimate goal, we must shift our focus to more effective management for individuals already diagnosed. This will help mitigate the risk of other complications.

Diabetes Risk Factors

There are many health and lifestyle factors that affect someone’s diagnosis. Those who are severely overweight or have a larger midsection than hips are at higher risk for developing T2D. Inactivity in these individuals leads to a condition called Sarcopenia, age-related muscle loss. 

When paired with weight issues, these risk factors contribute to the majority of insulin-resistance leading to diabetes. This may also explain the lack of success in older participants during the Diabetes Prevention Program.

However, for those diagnosed later in life, age-related comorbidities may be the highest risk factor. These additional medical conditions may have a negative impact on diabetes care, health status, and quality of life for those diagnosed.

Additional Concerns For Diabetic Seniors

Older adults with diabetes and at least one other health condition have even more to be concerned about. These individuals require more in-depth communication and individualized treatment plan beyond the general, “stay active and eat healthy” approach. 

Adults with diabetes may either be diagnosed before or after the age of 65. Termed either Long-Standing or Incident variations of the disease, these two groups differ in a number of ways. This adds to the complexity of T2D, making generalized treatment recommendations for older patients difficult. 

Make sure to find a doctor who is willing to hear all your concerns, additional conditions, and tailor the treatment plan to your individual needs.

Effects of Adult-Onset Diabetes

Older adults with diabetes have an increased risk of major lower-extremity amputation, heart attacks, loss of vision, and end-stage renal disease. And it seems the older the individuals, the higher the risk. Those 75 or older have higher rates of complications as well as hyperglycemic crises. 

Despite these high-risk conditions, many studies exclude seniors with diabetes in treatment plans. While this may be due to the multiple health conditions affecting this population, the lack of studies makes creating treatment options quite difficult. It seems, for now, lifestyle changes and strict glucose monitoring are the most effective options.

Effective Lifestyle Changes For Diabetic Seniors

Positive changes in some lifestyle factors have been found to reduce the progression of type 2 diabetes. These factors include:

• 
  Reducing or Quitting Smoking Habits
• Increasing Fruit & Vegetable Consumption
• Weight Loss 
• Regular Moderate to Vigorous Physical Activity

However, a recent study discovered while immediate lifestyle changes were made after the diagnosis, certain lifestyle factors showed no change. For example, those diagnosed with Incident Diabetes increased their physical activity and quit smoking, however, no changes were seen in body weight or diet. As time progressed, body weight was found to increase, and smoking picked back up.

Tools for monitoring lifestyle factors, goal-setting, and frequent communication for people with T2D may help them achieve and maintain positive lifestyle changes. Each individual is different, with varying additional conditions, and may need a more specific treatment plan. 

Diabetic Treatment Options

Lifestyle changes are often paired with Metformin for treatment. However, patients with multiple diseases or taking multiple medications require close monitoring of lifestyle changes for 3-6 months before beginning Metformin therapy.

While Metformin is the primary treatment option for elderly diabetics, many hypoglycemic drugs and insulins can be safely used with some restrictions. In general, those with a low risk of hypoglycemia should be preferred as oral or injected agents. 

Regimens containing as few drugs as possible should be administered, and only when immediately necessary. If deemed appropriate, the medication should start with a low dose and slowly increased over time as needed. 

It’s important to understand the different impact diabetes and additional medical conditions may have on patients 65 years or older. Careful consideration must be taken with treating older adults, and while more research is needed to find more effective treatment options, physicians must take responsibility to understand their patients’ perspectives and preferences. 

As well, it is the patients’ responsibility to commit to the appropriate lifestyle changes to see a reduction in diabetic symptoms. Simple steps such as adding more vegetables and fruit to a meal, consistent glucose monitoring, and daily walks may alleviate the need for further medications or surgeries.

Ocana Medical Center has a wealth of experience in the treatment of seniors with diabetes. We want to be your source for quality healthcare. Call for an appointment today. #ocanacares