Diabetes Struggles of Seniors & Family Caregivers – Our Dietitian’s Insights

Saying diabetes is a difficult disease to get and keep under control is an understatement.

When family caregivers are trying to help senior loved ones manage a diabetic condition that onset late in life, driving the need for changing diet and habits, it can be even harder.

Still, if your senior is among the 26 million Americans diagnosed with diabetes, you know how important control over diabetes is to how they feel and their overall wellness.

Did you know?

  • Of the 25.8 million diabetic people, 10.9 million are over 65
  • The direct medical costs of diabetes in 2007 was $116 Billion (and is higher now) and is twice the cost of those without diabetes
  • There is an estimated 7 million people who are undiagnosed but have diabetes
  • Diabetes was the #7 cause of death in 2010

A New Concern – Prediabetes

In the past, people were told that they were “borderline” and not really diabetic so didn’t take any action toward staying healthy. We now know that there are risks to this condition that require action and therefore there is a new diagnosis called prediabetes with guidelines for treatment.

Prediabetes is when an individual has blood glucose or A1c levels higher than normal but not high enough to be classified as diabetes. People with prediabetes have an increased risk of developing type 2 diabetes, heart disease, and stroke. Studies have shown that people with prediabetes who lose weight and increase their physical activity can prevent or delay type 2 diabetes and in some cases return their blood glucose levels to normal.

Potential Complications from Uncontrolled Diabetes

  • Heart disease and stroke
    • Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.
    • The risk for stroke is 2 to 4 times higher among people with diabetes.
  • Hypertension (high blood pressure)
  • Blindness
    • Diabetes is the leading cause of new cases of blindness among adults aged 20–74 years.
    • In 2005–2008, 4.2 million people with diabetes over 40 had diabetic retinopathy, and of these, 655,000 had advanced diabetic retinopathy that could lead to severe vision loss.
  • Kidney disease
    • Diabetes is the leading cause of kidney failure, accounting for 44% of all new cases of kidney failure in 2008.
    • In 2008, a total of 202,290 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant.
  • Other Complications
    • Almost 30% of people with diabetes over 40 have impaired sensation in the feet. Diabetic nerve disease is a contributing cause of lower-extremity amputations.
    • More than 60% of non-traumatic lower-limb amputations occur in people with diabetes.
    • Periodontal (gum) disease is more common in people with diabetes. Adults over 45 with poorly controlled diabetes (A1c > 9%) were 2.9 times more likely to have severe periodontitis than those without diabetes.
    • People with diabetes are more susceptible to many other illnesses. They are more likely to die from pneumonia or influenza than people who do not have diabetes.
    • People with diabetes over 60 years are 2–3 times more likely to report an inability to walk one-quarter of a mile, climb stairs, or do housework compared with people without diabetes in the same age group.
    • People with diabetes are twice as likely to have depression, which can complicate diabetes management, than people without diabetes.

Treatment Plan for Diabetes

OK, those are startling statistics. If you don’t control your blood sugar when you have diabetes, you are at strong risk for tragic complications. If you don’t yet have diabetes, improving certain lifestyle factors will help you prevent becoming diabetic. Following a treatment plan is not easy and it does take effort and attention to something every day but the benefits are worth the trouble of adherence.

  1. Medications – if your doctor prescribed medications, it is important to take them as directed. Certain times of the day for dosing oral agents or insulin is vital. What medications you begin on is not what you should stay on forever and they will need adjustments along the way so be sure to communicate any physical changes to your doctor.
  2. Blood Sugar Monitoring – your doctor, diabetes educator or dietitian can help you understand your glucose monitoring system. It is important to take your readings as directed waiting two hours after a meal (or any food) for the most accurate results. Log your findings or use the computerized report on your machine. As a dietitian, I counsel my clients to record notes along with the readings. If the number is out of the ordinary what was happening? Did you eat out, go to a party, do more or less physical activity, or are you unwell? This note will help the doctor make changes or decide not to change things when you visit. You might not remember three months later so good note taking will be helpful.
  3. Physical Activity – getting active and staying active every day with 30 minutes of movement will help control your blood sugar, blood pressure, heart health and weight management. The benefits are far reaching. Pick an activity you enjoy like walking, biking, swimming, or dancing. Finding something you love will help you stick to it. Find a buddy who will join you and motivate you toward staying active.
  4. Diet – this is a very important part of all diabetics program. Portion control, complete meals, high fiber choices, lower fat options, and non-caloric beverages will help control your carbohydrate load and calorie intake. Follow the MyPlate.org plan to keep your plate balanced and portions from overwhelming your health. If you need to lose weight, even five pounds will be beneficial to start, you should follow a plan that helps you to accomplish your weight goals. Achieving a healthy weight will help control your blood sugar and heart risk factors.

Most questions I hear from diabetics and their families are about diet and what foods to eat or not eat. Because what you hear from friends or read on the internet can be confusing and often wrong, we will dedicate a full post soon on diet alone to help control diabetes.

If you have questions about diet and diabetes that you would love to get answered, email them to me at Kathy (at) Seniorcarecorner.com and I will answer them in our next post on diabetes. Please keep in mind I cannot discuss specific situations.

Diabetes control takes a full approach and controlling one aspect without all the other aspects will leave you struggling. Diabetes care and education is covered as a Medicare benefit so if you need a refresher course, ask your doctor for a referral to a certified diabetes educator and/or dietitian today.

We look forward to answering your questions!