Diabetes Guide for Older People

How to Manage Your Diabetes as You Grow Older

Diabetes requires careful treatment. A healthy diet and exercise along with medicine are the mainstays of treatment. It is important to follow your healthcare professional’s instructions as long-standing uncontrolled diabetes can cause serious problems, including damage to your eyes, nerves, and kidneys. As you get older, your treatment may need to be changed, making it important to visit your healthcare professional regularly.

Eat Healthier Foods
All people with diabetes should eat a healthy diet that is low in sugar (including sugar from fruit). Mono and polyunsaturated fats are recommended in moderation. Avoid or reduce unhealthy fats (eg, saturated, trans fat). It may help to see a diabetes educator or nutritionist to help you create a healthy meal plan.

Mono and polyunsaturated fats are recommended in moderation.

  • Fish high in omega-3 fatty acids include salmon, fresh tuna, trout, and sardines.
  • Plant sources of omega-3 fatty acids include ground flaxseed, canola oil, soybean oil, nuts (eg, walnuts) and seeds (eg, sunflower).

Get Regular Exercise
Exercise is an important part of diabetes management and can help you lose weight (if you need to), lower your blood glucose level, and improve your cholesterol level. The American Diabetes Association recommends 30 minutes of aerobic activity at least 5 days a week, and strength training at least 2 times per week. You can split up the exercise into 10-minute workouts 3 times a day.

Examples of aerobic and strength-training exercises are shown in the Table. Always talk to your healthcare professional before starting a new exercise program to see if it is right for you.

If you have trouble walking, chair exercise programs are available on DVD, online, or at local community centers or gyms. “Chair classes” are even available on local PBS television stations.

Work with Your Healthcare Provider to Find the Best Medicines
Treatment depends on the type of diabetes that you have:

  • Type 1 diabetes: Insulin therapy is needed as soon as type 1 diabetes is diagnosed.
  • Type 2 diabetes: Some people in the early stages of type 2 diabetes can manage their condition with diet and exercise. People who do not respond to meal plan changes and exercise alone also need to take an oral medication and/or insulin therapy.
  • Latent Autoimmune Diabetes in Adults (LADA): People with LADA may be able to take oral medicines to manage their disease for a few months, but usually need switch to insulin therapy.

Oral Diabetes Medicines
The first oral medication that doctors typically prescribe for type 2 diabetes is called metformin, which helps the liver (our storage for glucose) from delivering too much into the bloodstream, helping to reduce blood glucose levels, especially overnight. Because diabetes is usually a progressive disease (meaning that it gets worse over time), your healthcare professional may need to add another diabetes medication or prescribe insulin to help you control your blood glucose levels. A variety of different types and brands of oral diabetes medicines are available and are used alone or in combination.

Insulin Therapy
If your body no longer makes enough insulin or doesn’t use it properly, you may need to take insulin that is made in a laboratory and mimic human insulin. Insulin therapy is injected under the skin is given with meals so that it can help your body process glucose in the foods you eat. The amount of insulin that you need depends on the foods you eat, when you eat, how much and when you exercise, and other factors.

A variety of types of insulin are available and differ in how fast they work, when they peak (or reach their maximum effect), and how long they last. In addition, insulin can be given in a variety of ways including a needle and syringe, insulin pen, and insulin pump. Talk to your healthcare professional to see what type is best for you.

It is best to inject the insulin in the same general area of the body (such as your abdomen, thigh, buttocks, or arm) to give consistent results. Insulin will enter your bloodstream fast when injected into the abdomen, slower when injected into the upper arm, and the slowest when injected into the thighs or buttocks. Be careful to not inject insulin near the same exact spot each time as hard lumps may develop under the skin. It is important to rotate sites from injection to injection to reduce the risk of lumps. 

Thus, it is important to understand how to use insulin therapy. Talk to your healthcare professional or a diabetes educator to make sure that you are using insulin therapy correctly.

Never Miss a Dose
Follow your healthcare professional’s instructions carefully and never miss a dose of medication or insulin. It is easy to forget if you have taken your medication, so make sure that you have good reminder systems in place such as pill boxes, a written chart, and alarms on your phone, watch, or clock.

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