Elderly Diabetes

Signs, Symptoms, Tips and More

Elderly Diabetes is prevalent in older adults. Almost 50% of people with Type II diabetes are older than 60.

Many people with diabetes are unaware they have the condition and may go years before they are diagnosed.

This can be especially true for seniors, whose symptoms can be less apparent, overlooked as "normal aging" or not apparent at all.

Diabetes, or diabetes mellitus, is when an individual has high blood sugar because their body doesn't produce enough insulin or because cells don't respond to the insulin produced. Insulin is a hormone produced by the body to control blood glucose (sugar) levels.

Seniors at higher risk for Elderly Diabetes are those who:

• Have a family history of Diabetes
• Are of Aboriginal, Hispanic, Asian, South Asian or African descent
• Gave birth to a baby weighing over 4kg (9 lbs) or had gestational diabetes

There are many rare forms of Diabetes but the most common are Type 1 and Type 2 Diabetes.

Type 1 Diabetes - Is when the body becomes unable to produce insulin. This type requires that a person inject insulin into their body to compensate. Most people who are affected are healthy when they develop Diabetes Type 1. Type 1 Diabetes can affect both children or adults.

Type 2 Diabetes - Is when your body becomes insulin resistant. Either the cells are unable to properly use the insulin produced and/or there is reduced insulin made by the body. Type 2 diabetes is more common than Type 1.

Pre-diabetes is when a person's blood sugar levels are higher than normal but not so high that they are diagnosed with Type 2 diabetes. The goal when someone is diagnosed with Pre-diabetes is to prevent Diabetes from developing. See below for tips for minimizing the risk of developing this disease.

Once Diabetes is diagnosed , the goal is to keep blood sugar levels as close to normal (between 4 and 7) as possible through diet, exercise and medications. Medications used are insulin for Type 1 Diabetes while Type 2 Diabetes can be controlled through both oral medication and insulin.

People with well-managed blood sugar levels are at a much lower risk of developing complications. It is important that the person understand the disease and how to manage it. This will increase their active participation in their care - which is essential.

Signs and Symptoms

Signs usually develop more quickly (weeks or months) with Type 1 diabetes

Symptoms may be hard to detect or absent with Type 2 Diabetes

• Frequent urination
• Increased and unusual thirst
• Lack recognition of thirst with subsequent dehydration
• Increased hunger
• Blurred vision
• Increased depression
• Impaired cognitive function
• Extreme fatigue, nausea, vomiting
• Change in weight (loss or gain)
• Impaired physical function
• Greater number of injurious falls
• Cuts and bruises that are slow to heal
• Tingling or numbness in the hands and feet
• Increased incidence of pressure ulcers
• May have increased infections of the bladder, skin, vaginal areas
• With extremely high blood sugar levels: coma
• For men, trouble getting or maintaining an erection

Diagnosing Diabetes

The only way to be certain your loved one has Elderly Diabetes is to have them take a blood test ordered by the doctor. Screening every 3 years for anyone above age 40 is recommended or every year for individuals over 40 with other risk factors.

Complications of Diabetes in Elderly

• Blindness
• Heart disease
• Stroke
• Kidney failure
• Erectile dysfunction
• Nerve damage
• Reduced blood supply to the limbs, which could lead to amputation in extreme cases
• Cataracts
• Skin infections
• Pneumonia
• Restless leg syndrome
• Pressure sores or skin infections
• Peripheral vascular disease and difficulties with circulation
• Overflow incontinence - bladder is unable to empty and frequent urination of small amounts day and night as Diabetes affects the bladder muscle's ability to contract
• Vascular dementia

Elderly Diabetes puts a person at very high risk for vascular dementia. Vascular dementia, or multi-infarct dementia, is caused by one or more strokes. Strokes are blood clots that block one of the arteries supplying blood to the brain.

Blindness can result from Diabetic Retinopathy as a result of poor blood sugar control. Diabetic Retinopathy is primarily caused by gathering of new blood vessels on the light sensitive area at the back of the eye - the retina - or leakage of the blood vessels that feed the retina. Blood fills the centre of the eye, causing blurring of vision. Left untreated, blindness can result. Unfortunately, by the time there are symptoms, there is often already major damage done.

An annual eye exam with dilation of the pupils can often detect Diabetic Retinopathy before symptoms and damage appears. This is an essential part of Diabetic care and recommended for anyone with a family history of Diabetes or Retinopathy.

Long-standing or poorly controlled Elderly Diabetes can lead to nerve damage in the feet which can affect a elderly person's balance and increase falls.

Men who have vascular problems may not get enough blood flowing to the penis. Nerve damage from elderly diabetes can cause erectile problems. In over 50 % of men who are diabetic, the first sign of the illness is decreasing firmness of erections.

Minimizing the Risk

Even if a person is elderly or has other risk factors, prevention of the onset of Type 2 Diabetes is possible by making simple, healthy changes in lifestyle:

• Don't smoke or stop smoking
• Achieve and maintain a healthy weight
• Be physically active. Regular activity not only reduces the risk of Diabetes but also improves overall physical, emotional and social well being in older adults.
• Limit your intake of fat and sugars
• Eat regular, balanced meals that include the four food groups (grains, vegetables and fruit, milk products, meat and alternatives)
• Keep cholesterol low
• Maintain a normal blood pressure

These changes can make a huge difference in health, independence and quality of life for your loved one, no matter their age and condition.

Suggestions for eating well to help control or prevent Elderly Diabetes:

• Eat lots of vegetables and fruits. Try to eat a variety including dark green and orange veggies and fruit more often.
• Try to eat high fibre foods such as whole wheat varieties of bread or pasta, oats, barley or rye, brown rice, bran cereals. Add beans, barley and lentils to your favourite dishes.
• Try to choose leaner meat and low-fat alternatives. Chicken, fish, tofu, lean beef, low-fat yogurt or cottage cheese.
• Drink more water, especially in hot weather and during activities that increase the heart rate.

Limit..

• Intake of sugar, salt, caffeine, alcohol and soft drinks.

If You Have Diabetes

• Ensure you have a yearly eye exam to detect early Diabetes Retinopathy that can lead to Diabetes related blindness
• Check cholesterol regularly.
• Refer to a dietician or nutritionist that specializes in Elderly Diabetes management regarding your diet
• Ensure proper foot care. Refer to Elderly Foot Care for tips on caring for the diabetic foot. Diabetic socks and shoes may also be recommended by the client's physician or registered foot care specialist.

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