The risk of developing diabetes, especially type 2 diabetes, increases when we are over 40.
There are many risk factors, such as weight management, physical activity, and high blood pressure or cholesterol, that can be controlled.
Lifestyle factors are actionable so seniors and their family caregivers can take steps to improve their health with the support of their healthcare team.
Unfortunately, not all seniors are benefitting from diabetes education for proper self-management.
Family caregivers are well positioned to help their senior loved ones improve their ability to manage their diabetes by connecting them with education and appropriate, easy to follow, individualized treatment plans.
Latest Report of Treatment Guidelines from the American Diabetes Association
Every year the American Diabetes Association (ADA) prepares a report with input from researchers, experts in the field, medical doctors, and others to guide practitioners, caregivers, patients, and payers to appropriate care and treatment.
Recently they published their latest report for 2018.
The goals for the care of diabetes expressed in this report:
- Timely treatment decisions based on evidence in collaboration with patient based on their needs, preferences, and other comorbidities (diseases). Improved self-management support is vital.
- “Care systems should facilitate team-based care, patient registries, decision support tools, and community involvement to meet patient needs”
- Creating quality diabetes treatment programs and evaluating their effectiveness to promote improved processes.
- The ADA encourages patient centered care which is respectful and responsive to the needs of the person with diabetes because one size does not fit all people diagnosed.
- Evaluate social factors such as food insecurity, financial barriers, and housing when creating a treatment plan and refer to community resources as needed
Despite all efforts to educate and manage diabetes in the population, the ADA reports that “33–49% of patients still do not meet targets for glycemic, blood pressure, or cholesterol control, and only 14% meet targets for all three measures while also avoiding smoking”.
Innovations for Improved Diabetes Care
This report details specific innovations and changes in the care of people with diabetes that can help seniors and everyone with diabetes (29 million currently diagnosed and 8 million more unaware that they have diabetes) manage their disease for health and prevention of complications.
Increasing the percentage of people who are managing diabetes will lower healthcare costs and side effects from uncontrolled abnormal blood sugar levels.
Using the latest technology can help lower the cost of care, reduce the likelihood of unscheduled medical interventions, help control medication adjustments and reduce complications due to better blood glucose control.
Here are some of the technology advancements available to seniors that can benefit their self-management:
- Apps provide improved blood sugar monitoring, communicating results in real time with the health team and caregivers so that emergencies can be avoided.
- Telemedicine, especially for those with limited access or transportation obstacles, when more frequent follow-up and monitoring occurs, blood sugar control, and medication adherence is improved.
- Electronic medical record (patient portal), which allow caregivers and seniors can view and track their lab work, have more individual contact with physicians and other health professionals, make appointments easier, and refill prescriptions, among other tasks.
- Text an educator or health professional using text either as part of the electronic health record or using smartphones, being in touch with an experienced person who can guide you and your senior if trouble or questions occur.
- Tracking medication adherence using electronic pill dispensers that will alert both caregivers and the medical team when medication is skipped or administered inappropriately
Reducing Cost of Care
Improved diabetes management will occur when the cost of care, supplies, medications, and a reduction in out-of-pocket expenses are controlled. This will improve treatment plan adherence.
The cost and availability of education and eye exams is an area needing improvement as well.
Continuous Glucose Monitors
Managing blood sugars without frequent finger sticks using a continuous blood glucose monitor will improve adherence to treatment plans. If a person with diabetes can keep blood sugar in better control without having to use strips or hurt themselves multiple times a day via fingerstick, they may be more apt to monitor as directed and administer medication accordingly.
Improved A1C Testing Procedure
Laboratory tests for A1C have in the past not been as accurate for certain groups of people. Advancements in testing procedures means that, especially for these people, a lab can be aware to use specific testing to overcome inaccurate results yielding more appropriate action based on the data. Ultimately meaning that more people will be able to manage blood sugars more effectively.
More emphasis has been placed on the connection between heart disease and diabetes. It is important to incorporate not only heart healthy lifestyle factors such as eating and activity but also be sure that medications do not contribute to heart attack and stoke for people with diabetes.
Some heart medications have been shown to potentially reduce the risk of heart disease and those should be used for people with diabetes.
Hypoglycemia in Older Adults
Low blood sugar has become a real concern for older adults managing their diabetes. The ADA recommends more education and close monitoring be done for older adults to prevent episodes of low blood sugar or hypoglycemia. Some older adults may be struggling with medication management and overtreating their diabetes. Using a drug regimen that is as easy to follow as possible is important for aging adults.
Putting Education Into Practice
All these advances can help our senior loved ones manage their diabetes and prevent adverse events from low blood sugar (or high blood sugar) as long as we advocate for them to get the individualized treatment plan and education they deserve.
Learning more about what foods to eat, heart health, weight management, physical activity, sick day care, and medication administration is key to a successful treatment plan.
Medicare pays for diabetes education as an annual benefit. One-on-one sessions with the diabetes educator and dietitian are a great way to create an individual care plan. Classes are available in most healthcare systems or wellness centers.
Family caregivers are able to attend diabetes self-management education sessions to help their senior manage their diabetes at home. If you haven’t taken a class or seen a diabetes educator, it is a good step in the right direction to control diabetes.