Aging Well with Diabetes
Diabetes in older adults is increasing around the world, mostly due to longer life expectancies. In Canada, 48% of people living with diabetes are over 65 years of age.
Although there is no universal agreed-upon definition of an older adult, it is generally accepted that the term older adult reflects an age continuum starting around age 70 and is characterized by a slow, progressive impairment in function that continues until the end of life. There are many people living with diabetes who are over the age of 70, who are generally healthy and have at least a decade of healthy life expectancy. No two older adults are alike and every older person living with diabetes should have an individualized diabetes care plan that takes into account current health, life expactancy and the individual's functional status rather than their age only.
Managing Diabetes
Managing diabetes in the older adult can present unique challenges. Age-related changes can mean that some symptoms will be harder to identify. Physical limitations and cognitive impairment in some older adults can limit or cause challenges to the self-management of diabetes.
Having a broad support system is important. Your support system could include: family members, friends, neighbours, primary care provider, a diabetes education program, pharmacist, home care providers, paramedicine program and other community programs.
Here are some suggestions:
1. Blood glucose targets should be individualized
- Speak to your diabetes care team to discuss appropriate blood glucose targets for you or your loved one. Often blood glucose targets should be set a little higher than what is suggested for younger people to try to avoid low blood glucose levels.
2. Symptoms of hypoglycemia (low blood glucose) may be more difficult to identify
- Older adults may have fewer symptoms or decreased awareness of low blood glucose levels. Symptoms such as confusion, inability to concentrate, morning headaches and sleep disturbances may be due to hypoglycemia. Checking your glucose levels more often or wearing a glucose sensor can help to determine if hypoglycemia is occurring.
- Aging can be a risk factor for hypoglycemia, epecially if you take certain diabetes medications. Speak with your diabetes educator, pharmacist or primary care provider to see if this risk applies to you and learn how to lower the risk.
- Click here to learn more about hypoglycemia; the signs and symptoms and how to properly treat.
3. Medications should be reviewed yearly
- Diabetes medications may need to be adjusted or changed as a person ages. A pharmacist is a good resource to review your medications. Ask your pharmacist for a free MedsCheck each year.
4. Healthy eating is important
- Eating healthy is important for managing diabetes. Older adults are at higher risk of under nutrition due to lower appetite, altered taste and smell, or eating difficulties due to dental disease. Some may also forget to eat or they may have difficulty shopping or preparing meals.
- Having healthy pre-prepared meals and snacks available or arranging a meal delivery service may be helpful. Drinking adequate amounts of fluids, especially in hot weather, is also important.
- Click here for more information on eating healthy while living with diabetes.
- Click here for information on how to start making healthy changes in your diet
5. Regular physical activity is important
- Regular physical activity is important to aging well. Before starting an exercise program, please speak with your primary care provider to determine if it is safe for you.
- Physical activity including both aerobic and resistance exercises helps to improve health and well-being and prevent falls.
- Click here for some physical activity tips for older adults.
- Click here for a resitance band exercise video from Diabetes Canada.
- Many community or seniors centres offer age-appropriate activities.
6. Symptoms of hyperglycemia (high blood sugar) may be more difficult to detect
- Symptoms of high blood sugar like weight loss, fatigue, headaches, blurred vision, increased urination or thirst, bladder infections, could be signs of elevated blood glucose levels. Checking your glucose levels more often or wearing a glucose sensor can help to determine if hyperglycemia is occurring.
- Click here for to learn more about hyperglycemia; the signs and symptoms and strategies to lower elevated glucose levels.
7. Foot care is important
- Checking your feet on a regular basis to check for cracks, cuts, ingrown toenails, caluses or open sores. This may be a difficult task for some older adults. If possible, ask a family member to inspect your feet regularly to look for any areas of concern.
- Your diabetes care team should also examine your feet during your appointment.
- If there are any areas of concern noted on your feet, or you are unable to cut your own nails, please inform your primary care provider or your diabetes educator. An appointment with a chiropodist, podiatrist or foot care nurse . For a list of footcare providers in Waterloo Wellington region, click here
- For more information on how to care for your feet, click here
8. Vision and hearing impairment
- Nearly 1 in 5 older adults with diabetes report visual impairment. Hearing loss is twice as common in people with diabetes at it is in those who don't have the disease. Eye exams and hearing tests should be performed on a regular basis.
- Click here to learn more about mantaining eye health
9. Depression and other mental health conditions
- Older adults living with diabetes are 2-4 times more likely to experience depression or anxiety than their peers who do not have diabetes. Symptoms may not present as sadness but as fatigue or memory issues.
- Others may experience diabetes distress which is different than depression. It is the emotional burden and frustration a person with a chronic disease may experience with managing a constant, demanding chronic disease.
- Depression, anxiety and diabetes distress can interfer with a person's ability to enjoy life as well as their ability to manage a chronic condition. Staying connected with your support system (family, friends, and your diabetes educator) can help.
- Click here for more information on mental health and diabetes
- Click here for more information on loneliness and diabetes
10. Economic Issues
If financial concerns are preventing you from being able to obtain required medications and supplies, appropriate nutrition or other diabetes services, there may be some provincial financial assistance programs available specifically for older adults.
"Syringes for Senoirs" is a program to help provide funding for older adults to supplement the cost of insulin pen needles and/or syringes.
Ask your healthcare team about programs and services that are available to help you manage your diabetes more cost effectively.
Other Helpful Resources
1. Living Well with Diabetes: A Caregiver and Family Guide. click here
2. Waterloo Wellington Self-management Program. click here
3. List of services in Waterloo Wellington region for older adults. click here
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