Focusing on the management of diabetes in elderly individuals – aged 65 years or above – primarily requires correct diagnosing of the condition. Since elderly people are at an increased risk of developing other diabetes related complications like heart, liver, kidney and eye problems, it is necessary to carry out expert diagnosis of diabetes.
What are the Symptoms of Diabetes and Ways to Diagnose?
While the general early symptoms of diabetes – both diabetes type 2 and 1 – for any average aged individual includes increased thirst, frequent urination, weight loss and blurred vision, the same are not prevalent in elderly people with diabetes. Elderly people suffer from other symptoms like dehydration, dry eyes and mouth and confusion in case of high blood sugar levels.
Diagnosis of Diabetes Type 2 in Elderly
The four main tests used to diagnose diabetes among senior citizens according to their blood sugar levels include:
- Casual blood glucose test
- Fasting blood glucose test
- Oral glucose tolerance test
- A1C test
It is important to note that in case of elderly, the A1C test does not give accurate result as their age factor is bound to increase the A1C. The other tests are hence recommended to arrive at accurate diagnosis. This also helps to ascertain what is normal blood sugar level for them.
Target Range of Blood Glucose Levels in Elderly
- If at all A1C test if conducted, the target range should be 7.0%.
- Fasting blood glucose (before eating a meal): 4.0 to 7.0 mmol/L.
- Blood glucose two hours after eating a meal: 5.0 to 10.0 mmol/L.
In case of elderly who become frail or extremely weak due to or leading to excessive weight loss, exhaustion, slow walking and low levels of physical activity, recommended fasting blood glucose for the frail elderly is 5.0 to 12.0 mmol/L.
Factors Responsible for Increasing the Risk of Diabetes
While age is obviously a major contributor to increasing the risk of diabetes among elderly, other dominant factors include:
- High blood pressure
- High levels of LDL cholesterol
- High levels of triglycerides
- Symptoms of depression
- Reduction in ability to perform activities of daily living
- Reduced mentation
High blood sugars among elderly also lead to dementia and vice versa.
Prevention and Management of Diabetes
Steps to manage blood glucose levels among elderly for prevention of diabetes include:
Lifestyle: Like with every diabetic, planning a healthy diet and following an exercise regime on a regular basis takes care of diabetes management for the elderly too. Consult your healthcare team to plan it best as per your needs.
Medications: Metformin is the most commonly prescribed medicine for type 2 diabetes, especially in case of elderly people. Other drugs prescribed are also helpful in managing blood glucose but should be used with caution as these may also increase the risk of hypoglycemia.
Insulin: For elderly people with type 2 diabetes, due to ease of use and efficiency, premixed and prefilled insulin pens are prescribed instead of the ones which need to be mixed. This reduced the risk of dosage errors.
Keep a Log of Readings: As part of self-management of diabetes, elderly should maintain a log of their glucose readings. Use a compact glucometer to get readings from the comfort of your home and discuss the patterns with your personalized diabetes educator or doctor.
Get Regular Tests Done:
It is important to undergo the following regular checkups to ensure you are aware of effects of diabetes.
- Yearly eye exam
- Annual kidney checkup
- Bi-annual dentist visit
- Regular feet exam by checking for any abnormality. Discuss with your doctor immediately upon any abnormality.
Apart from all this, the most critical aspect is to keep a strict check on your blood sugars using a glucometer and record the readings in a diabetes management app.