Managing Type 2 Diabetes In the Elderly

Type 2 diabetes is a chronic disease that affects millions of elderly people around the world. Managing type 2 diabetes in the elderly can be difficult due to the complex interplay of aging, multiple chronic conditions, and the possibility of cognitive and physical decline.

To ensure optimal diabetes management and prevent complications, older adults with diabetes must receive individualized care that takes into account their overall health status, comorbidities, and treatment preferences.

Type 2 diabetes is becoming more common as individuals live longer and put on weight.

Older people (>65 years) with diabetes are at higher risk of developing a comparable spectrum of microvascular issues as their younger counterparts, even if they may be at a lower absolute risk if they are diagnosed with the condition later in life, which would limit the disease’s duration.

On the other hand, compared to younger patients with diabetes, their absolute risk for macrovascular problems is significantly higher.

They also have a significant risk of polypharmacy, functional limitations, and other typical geriatric disorders, including depression, urine incontinence, falls, and chronic pain.

Managing Type 2 Diabetes in the Elderly

Older adults need to take more precautions to stay healthy and fit because the body starts growing weaker and the risk of complications greatly increases. Here are certain measures that must be taken in order to control type 2 diabetes in older adults.

Staying physically active

The benefits of staying active as we age include improved insulin sensitivity, muscle strength, mobility, and balance. It can enhance your mental health, help you maintain self-care, and keep you from falling. You should try to exercise as much as you can.

It has been demonstrated that balance and light resistance training are beneficial for older people, including those who are frail.

A physiotherapist can instruct and provide support for individuals who are housebound and confined to a bed or chair in exercises to increase limb strength and flexibility. Always consult your doctor before beginning a new exercise regimen.

Choosing the Right Food

Dietary recommendations for an elderly diabetic patient may occasionally deviate from general advice.

In nursing homes, older residents are frequently underweight rather than overweight, and undernutrition is common.

For some elderly diabetics, reducing their intake of fat, salt, and sugar may not always be necessary. Furthermore, hypos are frequently brought on by bad or irregular eating.

Food discomfort can also be brought on by poor oral health, certain medications’ effects on the digestive system, and physical limitations in terms of mobility, dexterity, or vision.

Elderly people frequently consume less fluid than younger people, which can lead to dehydration, especially when they are ill.

People who are at risk should receive a nutritional evaluation and individualized guidance from a dietitian to address areas of concern like the need for extra calories, meal supplements, and replacements, weight loss, a low-sodium diet, or manageable foods.

A nutritional evaluation and diet should be a component of your personal care plan if you live in a nursing home.

Older persons with diabetes should be able to continue to enjoy a broad variety of meals, and every diet plan should take into consideration the unique dietary preferences of the individual.

In order to understand the unique requirements of people with diabetes, staff members, including those who provide food, should receive training.

Taking care of their mental well being

Although it may go unnoticed in diabetic elderly individuals with complex medical issues, depression is more prevalent in people with long-term conditions.

Depression may be exacerbated by painful neuropathy, foot ulcers, or the negative side effects of medication. As people age, their risk of developing dementia also rises.

You might find it more difficult to successfully manage your diabetes if something negatively impacts your mental health.

Your doctor can administer quick tests to check for dementia or depression in diabetic adults. Early identification of these problems can reduce the long-term effects of these problems.

It is advised to screen diabetics older residents of nursing homes upon admission and on an annual basis.

Managing Hypoglycemia in the Elderly

Hypoglycemia, or “hypos,” is a very common incidence in older individuals. Less than 4 mmol/l of blood glucose causes this to happen. Older individuals may have additional risk factors that can result in hypo:

• having additional diseases or ailments.
• persistent renal issues
• Injectable insulin or particular diabetes drugs
• poor dietary habits

Hypos that are ignored can result in extremely unpleasant symptoms, including:

• aggressive attitude
• instability and slips
• difficulties with speech and self-care
• lack of appetite
• becoming unconscious
• psychological harm
• cardiac arrest or brain injury.

Many elderly people notice that their hypo-warning symptoms fade over time, and some even experience none at all. According to this, the first symptoms that a caregiver may notice are:

• difficulty concentrating
• change in personality
• daytime headaches
• disturbance in sleep.

 Treatment of Hypoglycemia

An unconscious person with a hypo should be given fast-acting glucose as soon as possible, such as in the form of a sugary (not hot, not milky) drink or some glucose tablets, and then they should eat something starchy, such as biscuits, a sandwich, or their next meal.

Make a call for an ambulance or medical assistance if someone is not breathing.

Regular carbohydrate-rich meals and snacks are beneficial for preventing hypos, as is knowledge of the signs of a hypo and how to spot people who may be at risk.

Blood glucose control goals shouldn’t be set too strictly, and the patient’s medication must be appropriate.

Although longer-term blood results like HbA1c must always be taken into account to provide a complete picture, blood glucose monitoring can help identify older people who may be at risk of hypoglycemia.

Developing a self-care routine

Your ability to care for yourself may be hampered by physical changes brought on by diabetes as you age.

Changes can occur at any time, so they might also be a warning sign that something needs to be investigated. You might need to change medications, so this is another reason to take notice.

Diabetes in older adults is associated with a number of complications. The most frequent cause of common eye conditions like glaucoma, cataracts, and macular degeneration is aging.

Urinary incontinence is a symptom that can be caused by a wide range of diseases, including poorly controlled diabetes and altered kidney function.

It is crucial to seek guidance for any new symptoms and to request assistance when self-care and monitoring have grown to be challenging for you.

To avoid all sorts of complications you must follow the instructions given above and develop a personalized self-care routine for the sake of your healthy future.

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