How does diabetes affect older people?

In recent years, an increase in diabetes has been detected in the population. What is this increase due to? Can diabetes be prevented? How does it affect the elderly?… We answer your questions.

Diabetes is a global problem with a tendency to rise and even double in the coming years. It is a disease that has also shown a higher percentage in people over 65 years of age and a sharp increase after 75. What is the reason for this increase? Can diabetes be prevented? How does it affect older adults?

What is diabetes?

First of all, we need to know what this disease is, and for this, we have the WHO definition:

“Diabetes is a chronic disease that appears when the pancreas does not produce enough insulin or when the body does not effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. The effect of uncontrolled diabetes is hyperglycemia (increased blood sugar), which over time severely damages many organs and systems, especially nerves and blood vessels.”

What types of diabetes are there?

According to the diabetes foundation, this disease is prevalent in the general population. The two main types of diabetes are type 1 diabetes, previously called childhood-juvenile diabetes, and type 2, known as adult diabetes.

Type 1 diabetes is more common in children and young people and affects life. It is usually caused by an autoimmune process, which involves the cells of the pancreas that produce insulin. In this case, the cells produce little or no insulin. Generally, patients with this type of diabetes must be treated with daily insulin injections to lower sugar in the blood. Despite all the research, there is currently no treatment to prevent this type of diabetes.
Type 2 diabetes appears mostly in adults. The body may not make or use insulin well. The latter accounts for around 90% of all diabetes cases, and its incidence has been increasing in recent years due to an increasingly sedentary lifestyle and an unbalanced diet. Thus, the prevention of this disease plays a vital role. It is crucial to detect people at risk of presenting it to establish preventive criteria.

Symptoms of type 2 diabetes

In this post, we will focus on type 2 diabetes because it is the type that occurs most frequently in the elderly.

Many older people with type 2 diabetes are often unaware they have the disease because symptoms are mild, come on slowly, and can be mistaken for aging itself.

That is why we must pay special attention if our elders present the following symptoms and go to the doctor as soon as possible:

I was feeling tired and sleepy.
Lose weight for no reason.
You want to eat or thirst.
Frequent urination.
Vision problems such as blurred vision.
Recurring infections.
Difficulty healing bruises or cuts.
Darkened areas of skin, usually in the armpits and neck.

How does diabetes affect the elderly?

Although the symptoms are more or less mild, the effects can be devastating. Over time, diabetes can damage the heart, blood vessels, eyes, kidneys, and nerves.

Older people with diabetes are at increased risk of heart attacks and strokes.
They are at increased risk for foot ulcers, infection, and ultimately amputation.
Diabetes can also be a significant cause of blindness due to accumulated damage to retinal capillaries over time.
Diabetes can also cause kidney failure.
In men, erectile dysfunction may appear.
With type 2 diabetes, hearing problems can develop.
Sleep apnea is prevalent in people with type 2 diabetes and obesity.
Type 2 diabetes seems to increase the risk of Alzheimer’s, although the reason is not known.

Causes or risk factors

Genetic or hereditary factor: in type 2 diabetes, family history and genetics play a significant role. The chances of having the disease are increased if a parent or sibling has it.
Lifestyle:
- I am having a low level of physical activity.
- I have an unbalanced diet.
- I had excessive body weight, mainly if the fat was concentrated in the abdomen.
Race: African Americans, Hispanics, American Indians, and Asian Americans are at higher risk for diabetes.
Age: in type 2 diabetes, the risk increases significantly after 45 years of age, although in recent years, it has also increased in children and young people due to obesity.
Prediabetes is a disorder not considered diabetes, but that affects blood sugar levels higher than usual.
Polycystic Ovary Syndrome: Women with this disease are at increased risk of developing diabetes. PCOS is characterized by having irregular menstrual cycles, excessive hair growth, and being overweight.
Gestational diabetes occurs when the body cannot make or use all the insulin it needs during pregnancy. This diabetes usually goes away within a few weeks of giving birth. However, some women do not return to normal blood sugar levels and are diagnosed with diabetes.

Diagnosis Type 2 diabetes

The most used to diagnose this pathology are blood tests to know blood sugar levels. Levels above 200 mg/dl detect diabetes. It will likely be repeated, or a second test will be needed to diagnose reliably.

Thus, several blood tests can be performed to make a proper diagnosis depending on the case and the person:

Random plasma glucose test: blood test at any time of the day when you have severe symptoms of diabetes.
Hemoglobin A1C test: this can be done at any time of the day and indicates the average glucose concentration over the last 2 or 3 months.
The fasting glucose test is done in the morning after at least 8 hours of fasting. This test measures the fasting blood glucose level.
An oral glucose tolerance test is done after an overnight fast and 2 hours after drinking a special sugary drink. Indicates how the body processes glucose.

In addition, the following recommendations can help the older person control diabetes and prevent other problems :

Check the skin and joints of the feet and legs. See also if they are number.
Check blood pressure once a year.
Check cholesterol and triglyceride levels once a year.
Check kidney function.
Visit the ophthalmologist once a year.
Visit the dentist every six months to perform a good oral cleaning and dental exam.
Keep the vaccination program up to date.
Quit smoking and drinking alcohol.

Treatment for the elderly

Keep glucose at controlled levels, measuring daily or several times a week blood glucose levels with a glucometer.
Maintain a healthy diet and reasonable weight control. It’s important to know what amounts of fat, protein, and carbohydrates are suitable for your diet. The ideal is to include the foods that the older person likes the most, but that adapt to the diet to be carried out.
Include regular physical activity. Exercise lowers blood sugar levels and helps you lose weight, and improves circulation and blood pressure. It also helps to have a good energy level and better manage stress.
Take the indicated medications if necessary, oral or injected:
- Metformin: lowers blood glucose levels and improves the body’s response to insulin; this is the most appropriate treatment for type 2 diabetes.
- Sulfonylureas: Oral medications that help the body make more insulin.
- Meglitinides: short-acting, fast-acting oral medications that stimulate the pancreas to release more insulin.
- Thiazolidinediones: Oral medications that cause increased sensitivity to insulin.
- DPP-4 inhibitors: milder drugs that help lower blood glucose levels.
- GLP-1 receptor agonists: slow down digestion and improve blood glucose levels.
- Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve glycemic control and help prevent the kidneys from reabsorbing glucose from the blood and sending it into the urine.
There are people with diabetes who have foot problems. In these cases, treat any issue such as infections or pain immediately, apply moisturizing lotions and choose the correct footwear.
Take care of emotional health and stress with activities that help the person relax, such as meditation, yoga, tai chi, listening to relaxing music, reading, taking deep breaths, etc.
In some cases, especially in obese older people, bariatric surgery is recommended by performing a gastric bypass. This prevents the transit of food through the jejunum and duodenum.

Finally, from Cuideo, we want to emphasize that type 2 diabetes can be prevented or at least delayed in many cases, and this prevention is as simple as trying to have a healthy lifestyle that includes a good diet, physical exercise to avoid a sedentary lifestyle, and adequate weight and a good emotional state.