Diabetes in seniors. What we have to know...

Diabetes is one of the biggest health issues in American medical history. Over 30 million adults in the United States have been diagnosed with diabetes. Another 84.1 million U.S. adults have what is known as “prediabetes” – conditions indicating the onset of diabetes. The World Health Organization says diabetes will be the seventh leading cause of death worldwide by 2030. While diabetes can strike anyone, seniors are more at risk, simply because their bodies have experienced more wear and tear….and more sugar! As we age, internal body functions may be compromised, and we may not get as much exercise as we once did. Approximately 25 percent of Americans 65 and older have diabetes, which equates to about 12 million seniors. Sadly, diabetes increases the chances of coronary disease, heart attack, and stroke in seniors. In fact, statistics show that heart disease and strokes account for approximately 65% of deaths in people with diabetes. So, while it’s important to manage blood sugar levels with diabetes, it’s also important to keep your heart healthy.

What is Diabetes?

Diabetes is a serious health condition that causes higher than normal glucose levels – also known as blood sugar levels. Glucose/sugar comes from the foods we eat.

Healthy bodies produce a hormone called insulin that processes the glucose we consume, sending it to our cells to create energy. When a body isn’t producing this insulin, it can’t process the body’s blood sugar properly, and blood sugar levels will skyrocket which can be life-threatening. There are two main types of diabetes:

Type 1 diabetes, also known as “juvenile diabetes” (even though it can occur at any age) is the most severe form of the disease. It occurs when the body doesn’t make any insulin – all insulin producing cells have been destroyed. Sugar stays in the blood and the cells starve. If untreated, these high blood sugar levels can damage eyesight, kidney, nerve, and heart health. It can be fatal. With Type 1 diabetes a person is totally dependent on daily insulin therapy.

Type 2 diabetes is the far more prevalent (90% of all diabetes) and common form of the ailment. It is a “non-insulin dependent” diabetes and far more treatable than type 1 diabetes. It is often called “adult onset diabetes”, since it typically develops after age 35. People with type 2 diabetes produce some of their own insulin, but it’s often not enough to manage blood sugar levels. People diagnosed with prediabetes need to be careful it doesn’t turn into type 2 diabetes. Prediabetes is when someone has higher than normal blood sugar levels, but not high enough for them to be considered diabetic. What Causes Diabetes?

The biggest causes of type 2 diabetes are:

1. Being overweight. This is usually caused by a diet that is loaded with sugar, carbohydrates, and non-nutritious foods.

2. A sedentary lifestyle and lack of exercise.Lack of exercise can contribute to weight management issues. If we don’t keep our body parts tuned up, strong, and healthy, they can’t combat high-calorie food, stress, and other medical issues.

Other factors include:

• Family history of diabetes

• High-density lipoprotein (HDL) cholesterol levels

• High blood pressure

• African-American, Native American, Latin American, or Asian-Pacific Islander descent

• Age of over 45 years

Ways to Help Prevent Diabetes

Weight management is one of the most important factors in preventing and managing diabetes. Not always easy, but very do-able. With healthy eating, exercise, and just a few lifestyle changes, diabetes can be mitigated; it may even disappear!

1. Eat healthy foods. Make sure your diet is nutritious and healthy. It should be a diet high in fresh foods including whole grains, fruits and vegetables, lean proteins (skinless chicken), low-fat dairy, and healthy fat sources such as nuts. Stay away from processed foods. A good place to start is the MIND diet, which is great for improving brain health in seniors.

2. Eat fish 2-3 times a week. Bake it, broil it, grill it. Don’t fry it.

3. Buy a vegetarian cookbook. There are delicious recipes today that are totally vegetarian, heart healthy, and weight conscious. You’ll be surprised.

4. Avoid high-sugar foods, empty carbohydrates, and trans fats. Stay away from foods with a horrendous calorie count and no nutritional benefit (also known as “empty calories”): coca cola and other sweetened sodas, fried food, and sugar-laden desserts. Even coffee can be a minefield for sugar, posing risk to people who are at risk of diabetes. “Carbs” can have the biggest impact on blood sugar levels. They may be delicious, but they turn right into glucose.

5. Read labels. Count carbs and sugar grams; avoid hydrogenated oils.

6. Go for healthy fats. This includes monounsaturated fats (olive oil, avocado, almonds, peanut oil & sesame seeds); omega-3 fatty acids (salmon, canola oil, tofu); polyunsaturated fats (sunflower oil, walnuts).

7. Try gluten-free, sugar-free, and vegan products. We are fortunate to have so many alternatives on the market today…many that actually taste good! That wasn’t always the case. Recognizing the health benefits of such products and the emerging market, manufacturers have stepped up to the plate.

8. Portion control. Invest in a small scale and weigh food in 3 oz. portions. Use a small plate so the smaller portions look like a large meal! Only eat half of what you’re given at a restaurant and take the rest home. Think sips and bites, versus inhaling everything at once.

9. Increase dietary fiber intake. 20-35 grams of fiber a day from whole grains, oatmeal, fruits, and veggies is recommended.

10. Limit alcohol intake. There is a lot of sugar in most alcohol. Doctors say women should limit their intake to one drink a day, and men to two drinks a day.

11. Exercise. The American Diabetes Association recommends at least 30 minutes of exercise a day, 5 days a week. Exercise helps process glucose and lowers blood sugar levels. Walking, water aerobics, or swimming, bicycling, dancing, tennis, chair yoga are all great. You can start slow – 10 mins/3 times a day. Make sure you have comfortable exercise shoes and comfortable exercise clothing. Sometimes exercising in a group provides more incentive and encouragement. There are lots of classes online as well as at local community centers and gyms.

12. Keep a weight management log. Write down everything you eat and how much you exercise every day. Record your blood sugar levels using over-the-counter monitors, and track your progress.

13. Manage stress & emotional well-being. It has been clinically proven that stress increases blood sugar levels.

14. Maintain general health. Again, a healthy heart and a healthy mind all set the stage for managing diabetes. Other medical conditions, infections, and health issues can complicate diabetes management, so staying in overall good health makes sense.

Care for Seniors with Diabetes

In general, caring for seniors with diabetes is all about ensuring they have a healthy diet and get some exercise. Keep the following in mind:

1. Insulin doses. Seniors with type 1 diabetes need to make sure their daily insulin dose is accurate. They may need help monitoring this. Too much insulin, and the blood sugar can drop to a dangerously low level. This is called hypoglycemia and can be life-threatening. Too little insulin, the blood sugar can rise to a dangerously high level. Cells will not be getting the sugar, or energy, they need. This is called hyperglycemia. Today, a wide range of computerized diabetes devices are available to help people better manage and monitor blood sugar levels.

2. Diet and exercise. Seniors with type 2 diabetes need to focus on ways to better use the insulin the body already produces to normalize blood sugar levels. This involves diet, exercise and weight loss as suggested above. If blood sugar levels are still high, medications may be necessary to help the body use its own insulin more efficiently.

3. Hydration. With all diabetes, hydration is critical. Poor hydration can trigger hyperglycemia (high blood sugar levels). Make sure seniors are drinking plenty of water.

4. Medication Management. Know and manage medications for seniors being used as they may impact blood sugar levels.

5. Foot care. According to the Diabetes Research Institute it’s important to pay attention to foot care for seniors with diabetes. Diabetes can cause a loss of sensation in the feet. Therefore, feet need to be manicured and monitored for wounds, ingrown toenails, infections, and other issues that the seniors may not be aware of due to the loss of feeling.

The good news is that fortunately, diabetes can be controlled and managed. It can even be eliminated in some instances; blood sugar levels can return to normal. Doctors regularly include glucose monitoring in routine blood tests for seniors, so make sure to start tracking this to establish benchmarks.