Diabetes is a life-long condition that will require additional treatment and medicines over time, even if you work hard to control it. It is important to work closely with your healthcare professional to make sure you are taking the right medicines, eating the right types and amounts of foods, and being more active.
Older people with diabetes are at greater risk than younger people with diabetes for cardiovascular disease (heart attacks and stroke), depression, hypoglycemia (low blood sugar), kidney disease, memory loss and dementia, and nerve pain. Talk to your healthcare professional if you are having any of these problems.
The risk for cardiovascular disease (heart attack and stroke) increases as we age—but even more so in people with diabetes. In addition to trying to reach your target blood glucose level, it is also important to reach goals for blood pressure and cholesterol. There are a variety of ways to control your blood pressure and cholesterol using meal plan changes, exercise and medicines.
Older people with diabetes are at increased risk for depression, but many people do not feel they need help for their depression. While managing diabetes (or any other chronic disease) is challenging, if you feel sad or hopeless for more than 2 weeks, talk to your doctor about treatment options. Depression can make it harder to manage diabetes and can make it hard to stay active and enjoy life. Talking to a therapist or counselor and possibly taking medications can help you feel better. Don’t wait to get help.
The risk for hypoglycemia (low blood sugar) increases as we age for a variety of reasons. One reason is that kidney function changes with age, putting older people at risk for hypoglycemia because the kidneys do not work as well removing the medicines used for diabetes, making them work longer. Another reason is that older people may have less of an appetite and skip meals or eat too little. Also, older people may not be aware of the symptoms of hypoglycemia, such as confusion, dizziness, hunger, blurred vision, and sweating. Some older people may need to take a lower dose of their diabetes medicine as they age, only if their healthcare professional recommends it. Thus, it is important to tell your doctor if you have any signs of hypoglycemia and what to do if you have these symptoms.
In addition, it is important to tell your healthcare professional and pharmacist about any over-the-counter and prescription medicines that you are taking as some can interfere with your diabetes medications, causing hypoglycemia.
People with diabetes, especially older people, are at risk for kidney disease. Often, there are no symptoms of the disease or the symptoms are varied, making them hard to detect. It is important to see your healthcare professional regularly so that he or she can check your blood pressure, urine, and blood for signs of kidney disease. Controlling your blood pressure through meal plan changes, exercise and use of medicines is a good way to help prevent kidney disease.
Long-Term Care Options
As many as 70% of older people will need help taking care of themselves as they age. This can include help at home getting dressed, bathing, and feeding themselves, or living in a nursing home or assisted-living facility. Medicare and health insurance typically do not cover this type of care, so it is important to have a plan in place and talk to your family about it. Information on long-term care options is available at the National Clearinghouse for Long Term Care Information’s Web site.
Older people with diabetes are at risk for memory loss and dementia. Tell your healthcare professional if you or your family and friends have noticed that you are having memory problems. All people with diabetes, but especially those with memory problems, need to make sure that they have reminder systems (alarms, pill boxes, notes, etc) in place so that they don’t forget to take their medicine or take too much medication.
The longer you have diabetes, the greater your risk for nerve damage (neuropathy). Nerve damage can happen in your hands and feet (peripheral neuropathy), causing pain, numbness, tingling or weakness. Nerve damage also can occur in the nerves that control organs in your body (autonomic neuropathy), causing bladder problems, erectile dysfunction, diarrhea, and stomach problems. Talk to your doctor if you have symptoms of these problems as there may be treatments that can help you.
American Diabetes Association. Hypoglycemia. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/hypoglycemia-low-blood.html?loc=lwd-slabnav. Accessed March 19, 2015.
American Diabetes Association. Kidney Disease (Nephropathy). http://www.diabetes.org/living-with-diabetes/complications/kidney-disease-nephropathy.html. Accessed March 19, 2015.
American Diabetes Association. Living Healthy With Diabetes. http://main.diabetes.org/dorg/PDFs/living-healthy-booklet-american-diabetes-assoc.pdf. Accessed March 19, 2015.
American Diabetes Association. Neuropathy. http://www.diabetes.org/living-with-diabetes/complications/neuropathy/. Accessed March 19, 2015.