Older adults are at higher risk of developing diabetes, with type 2 diabetes being the most common in this age group. People aged 65 years and over (21.4%) have the highest proportion of diabetes diagnoses among all age groups.
The American Diabetes Association recommends that adults over the age of 45 get screened for diabetes and prediabetes every one to three years, even if the results are still normal. Even with successful diabetes treatment, the risk of complications from blood vessel damage increases with age.
Symptoms of diabetes are the same for all age groups, including increased thirst, fatigue , and vision problems. However, the target blood sugar level for older adults is less stringent than the ideal range for other age groups. The diabetes management plan for older adults may also differ.
Management of diabetes over 65 years
Hypoglycemia occurs when blood sugar levels are below normal. It is defined as a blood sugar level below 70 mg / dL.
It is common among older people with diabetes. This may be due to the fact that older people are more likely to suffer from other chronic diseases, malnutrition, or take multiple medications.
Hypoglycemia can also result from taking too many medications that are used to lower blood sugar levels. Over-treating diabetes is common in older people.
Researchers say that hypoglycemia is most likely underreported because older adults may not experience symptoms of low blood sugar or may not be able to communicate their feelings to their caregivers due to cognitive decline.
Blood sugar levels
The goals of diabetes treatment for people over 65 are different from those for younger people and children. To avoid hypoglycemia, patients with multiple chronic conditions or those with an incurable diagnosis may have less strict control over their blood sugar levels. Older people in more stable health can control their diabetes with tighter control.
|Blood sugar goal in people over 65|
|Health condition||A1C||Fasting blood sugar||Blood sugar before bed|
|Few or no chronic, cognitive-functional health conditions||7.5% or less||90-130 mg / dL||90-150 mg / dL|
|Multiple chronic conditions, mild to moderate cognitive impairment||8% or less||90-150 mg / dL||100-180 mg / dL|
|Living in a long-term care facility, end-stage chronic illness, moderate to severe cognitive impairment||8% to 9%||100-180 mg / dL||110-200 mg / dl|
Blood sugar control
Regular blood sugar monitoring is an important part of any diabetes treatment plan. Checking your blood sugar level is done with a small needle called a lancet, which is pierced with the tip of your finger. A drop of blood is placed on the test strip and the meter will show your blood sugar level. In general, blood sugar levels should be checked before meals and at bedtime. Your doctor may advise you to check it more often.
Cognitive decline and chronic disease can make it difficult for some older people to safely follow their diabetes care plan, even if they have been successfully managing their condition for many years. In these situations, the healthcare provider may prescribe a lower dose of medication, involve caregivers in monitoring, and carefully assess blood sugar levels.
Medication is just one tool to treat diabetes. Diet is another way that people with diabetes can manage their condition because eating or not eating is what affects blood sugar levels.
However, following a healthy diet can be challenging for some older people due to gastrointestinal problems that occur with age, which can make eating difficult and put them at risk for unhealthy diets.
These problems can include:
- Swallowing disorders
- Indigestion and other intestinal problems.
- Feeling full too soon after eating
Older people may need to add nutritional care to their diabetes care plan. This is done under the guidance of a registered dietitian who creates a personalized meal plan that addresses the issues that make eating difficult.
Some strategies may include:
- Adding supplements, protein, or liquid calorie boosters to maintain weight
- Alleviate food restrictions
- Help with cooking, eating, shopping, or counting macronutrients.
Older people still need medicine to control their blood sugar level. They typically take multiple medications for other chronic conditions, so healthcare providers should exercise caution in choosing a safe and effective diabetes drug with the lowest risk of hypoglycemia and drug interactions .
The most common treatments include:
- DPP4 inhibitors (sitagliptin, saxagliptin, linagliptin, alogliptin): one tablet daily will help reduce the risk of hypoglycemia. Be careful with heart failure (saxagliptin and alogliptin) and dose changes if kidney function is poor.
- SGLT2 inhibitors (dapagliflozin, canagliflozin, empagliflozin): one tablet a day reduces the risk of hypoglycaemia. Empagliflozin is a good choice for people with heart disease and may help reduce the risk of death from cardiovascular disease in people with type 2 diabetes. However, this drug can have serious side effects, such as kidney failure, decreased blood density. bone and low blood pressure.
- GLP1 agonists (exenatide, exenatide ER, liraglutide, albiglutide, lixisenatide, dulaglutide, semaglutide): doses administered by daily or weekly injections. The preparation of Exenatide ER and Albiglutide can take a long time. Possible side effects include nausea, diarrhea, weight loss, and pancreatitis . Sometimes gastrointestinal side effects, such as decreased appetite, can be noticeable in older adults and lead to significant weight loss.
Get the word of drug information
It is perfectly normal for diabetes control and treatment to change with age. Whether someone has been recently diagnosed with diabetes or has had diabetes for decades, there are many ways to keep their blood sugar levels within the normal range and maintain a good quality of life.
It is important to note that blood sugar goals for older people differ from goals for people in younger age groups. Likewise, your treatment plan may be different, and older adults may need extra help to follow blood sugar management and treatment. Always check with your doctor before making any changes to your treatment plan.