Diabetes and Older Adults – A Comprehensive Guide

You have probably heard a lot about diabetes. Perhaps you even have relatives and friends who have the disease. However, if diabetes has not touched you personally, chances are you may not know enough about this growing problem. Here is some information we have put together that will add to your understanding. Regency Nursing and Rehabilitation Centers provide world class care for residents with Diabetes and our caregivers are extensively trained in this area.

What is diabetes?
In short, diabetes is a condition in which the body cannot produce enough of a hormone called insulin. Insulin is necessary for the body to process sugar and turn it into fuel the body can use. Without enough insulin, the organs are starved of vital nutrients, while blood sugar levels remain too high. If the condition persists, over time, organs become damaged and function poorly.

Some common consequences of untreated or improperly treated diabetes are loss of vision, poor circulation (often leading to wounds that will not heal or even amputation), nerve damage, stroke, kidney and heart disease. Because diabetes can damage cells and weakens the body’s defense systems, it can leave the body unable to fight infections and heal itself the way nature intended. As a result, people with diabetes are also more prone to develop complications from wounds, common illnesses like the flu, pneumonia and other bacterial or viral conditions.

Who is affected?
Diabetes can occur at any age and across all ethnic groups, although African- Americans, Hispanics, Asians, and Native Americans seem to be particularly vulnerable. The most common form is Type II diabetes, also known as Adult Onset diabetes, which affects over 17 million Americans, including an ever-increasing number of older adults. In fact, about half of all seniors over the age of 60 have diabetes, although many do not even know it!

Are there other risk factors?
In addition to older age and ethnicity, there are several other well-established risk factors associated with diabetes, including:
• Obesity

• Family history of diabetes

• Heart conditions

• High cholesterol levels

• History of diabetes during pregnancy

• Lack of exercise or physical activity

Complications of diabetes
Left undiagnosed and/or untreated, diabetes may lead to serious medical complications, including:

Heart disease. Heart disease is the leading cause of diabetes-related deaths, occurring at a rate two to four times higher than for those without diabetes.

Stroke. The risk of stroke is two to four times higher in people with diabetes.*

High blood pressure. An estimated 60 to 65 percent of people with diabetes have high blood pressure.

Blindness and Kidney disease. Diabetes is the leading cause of both blindness in seniors and end-stage renal disease, often necessitating dialysis or kidney transplant.

Nervous system disease. About 60 to 70 percent of people with diabetes have mild to severe forms of nervous system damage.

Amputations. More than half of lower leg amputations in the United States occur among people with diabetes.

What are the warning signs of diabetes?
Although often, in the early stages, there are no clearly identifiable symptoms, many people with diabetes may experience some of the following symptoms:

• Frequent urination

• Unusual thirst

• Extreme hunger

• Unintended weight loss

• Blurred vision

• Extreme fatigue

• Irritability

• Numbness in hands or feet

• Cuts and sores that are slow to heal

Remember, even if you do not have any of these symptoms, you should be tested regularly for diabetes, especially if you are over age 55!

Is there a cure?
While there is no known cure for diabetes, it can be controlled, given early detection, proper medical care and specific lifestyle changes. Unfortunately, diabetes often goes undiagnosed and, like all chronic conditions, diabetes will get progressively worse unless it is properly managed.

Inset:
Almost two out of every three people with diabetes also have high blood pressure.

How to control diabetes
The way to control diabetes is to keep blood sugar levels as close to normal as possible. Here are several important steps to take:

1. First, see a doctor. This is the most important thing to do if you think you have diabetes. Only a doctor can accurately determine whether or not you have the disease and the best approach for treating it.

2. If diagnosed with diabetes, take your medication as prescribed. There are many excellent medications available to regulate blood sugar that can be taken under the direction of your doctor.

3. Monitor your blood sugar level regularly. Without frequent and accurate measurements, you will not know whether you need to modify your medication and/or treatment schedule in order to maintain the proper blood sugar level.

4. Watch what you eat. Eat regular meals at about the same time each day. Skipping meals or not eating frequently enough can make your blood sugar level fall. Eat a variety of foods. Limit fats, sugar, salt and alcohol.

5. Be active. Physical activity may help you feel better, control your blood sugar and weight, and even help prevent heart and circulatory problems. Always be sure to consult with your physician before increasing your activity level or starting any kind of exercise program.

Inset:
If you think you have diabetes, the most important thing you can do is to see your doctor.

Managing and caring for diabetes
Early detection is the best way to keep diabetes from robbing you of a full and active life. Once diagnosed, diabetes is usually highly manageable. In fact, given the right medication, appropriate lifestyle adjustments, and the guidance of your physician, people with diabetes can generally remain productive and fully independent.

If diabetes progresses to the point where the individual alone can no longer manage it, there are home care services available that will help monitor and manage the condition. However, should the disease progress to a point where treatment for serious complications is needed, there are a number of continuing health care options and support available to match specific levels of need. These include:

Short-Term Rehabilitation Centers. Dedicated, stand-alone rehab centers, as well as many skilled nursing facilities, provide therapeutic care and specialized services often required by people dealing with diabetes and its complications. Services are typically rendered during the transition between hospital and home or alternate levels of care. Length of stays range from several days to several months, depending on the patient’s condition and his or her ability to function independently.

Long-Term Care Facilities. These facilities provide comprehensive services for people who require 24-hour skilled nursing supervision and daily care. Some offer specific diabetes management programs that include specialized care for those
in advanced stages of the disease and also treat related complications, such as complex wounds and kidney failure. Patients who suffer from kidney problems should be sure to select a long-term care facility that has nephrologist-supervised hemodialysis on site.