Diabetes and the Elderly

Over the years, the diet recommended for the management of diabetes has undergone many changes. The older and more traditional 'diabetic diet' of the past provides very little benefit to blood glucose control and can even place individuals at nutritional risk.

Today it is recognized that moderate amounts of sugar can actually be included in the diets of people with diabetes.

The food choices recommended for older people with diabetes are based on dietary guidelines developed over the years, emphasizing on consuming nutritious foods based on high fibre carbohydrates and healthy fats in moderation. A good balance of foods can improve blood glucose management, general wellbeing and also assist with weight maintenance.

Glycemic Index Explained

All carbohydrate foods we consume turn into glucose in the blood, doing so at different rates – some slow, some fast. The Glycemic Index (GI) is a way of describing how a carbohydrate containing food affects blood glucose levels.

Foods with a low Glycemic Index (GI) raise blood glucose slower than foods with a high GI. It is therefore recommended to consume at least three low GI foods throughout the day, ideally one with each meal, which in turn can help with overall blood glucose management. Carbohydrate containing foods that have a lower GI include: wholegrain breads, oats, legumes (including kidney beans, baked beans and lentils), corn, sweet potato, dairy products such as yoghurt, custard and milk, pasta and fruits such as apples, oranges and pears.

How about Sugar?

Research into the GI has shown that people with diabetes no longer need to avoid all sugars. We now know that sugar found naturally in or added to nutritious foods such as custards, yoghurts and even breakfast cereals should not adversely affect blood glucose levels and can in fact be part of a healthy diet. Small amounts of sugar can be included in the diet.

Examples include:

• Small carton of flavored milk, preferably low fat.
• Fruit or dairy based desserts such as custards, milk puddings and fruit crumbles.
• A teaspoon of sugar in a cup of tea or coffee
• A small amount of sugar or honey on high fiber breakfast cereal such as porridge.
• A thin spread of 100 per cent fruit spread or jam on a slice of toast.

Diabetes Management Challenges for Seniors

Seniors ultimately face unique diabetes management challenges. For seniors with type 2 diabetes, age causes a decline in insulin production and an increase in glucose intolerance. Seniors are also more likely to have complicating conditions such as hypertension, retinopathy and even kidney problems if not managed correctly.

Environmental and physical issues that may impact diabetes care for seniors include:

Transportation - Seniors who can no longer drive may have difficulty getting to medical appointments and keeping up with appropriate diabetes preventative care.

Economic Barriers - Seniors on a fixed income may skimp on appropriate diabetes care, medications and proper nutrition.

Isolation - Seniors may lack an adequate peer or a family support network for emotional and social support, which could lead to depression.

Mobility – Physical conditions such as arthritis that are more prevalent with age can prevent older adults from regular exercise. By age 75, approximately one in three men and half of all women are physically inactive.

Differences when diagnosing diabetes amongst the elderly compared to diabetes amongst the young

A number of physiological changes do take place as our bodies grow and adapt to their age. Elderly people who are at risk of developing diabetes or who have already developed the disease may not exhibit the typical symptoms expected.

Age-related changes can mean that some symptoms will be masked, or harder to spot.

Seniors Diabetes Frequently Asked Questions (FAQs)

What are the differences in treatment of diabetes amongst the elderly when compared to diabetes amongst the young?

Treating diabetes amongst the elderly can present unique challenges. Other disabilities associated with aging can contribute to the complexity of strictly self-managing diabetes. Impaired physical functioning amongst some elderly patients can mean that adjusting to a diabetes care routine is more difficult.

What are the risks when an elderly person develops diabetes?

Elderly people tend to be more frail and susceptible to illness. This can mean diabetes-related complications can be more common and harder to manage. Furthermore, exercise and adapting a diet can be more difficult for elderly people, and problems can arise.

Although many diabetes complications can affect seniors, cognitive complications are more common. Further problems may include undiagnosed depression, social issues, limited daily means and coexisting health problems.

Treating diabetes and goals

Managing diabetes amongst the elderly may often pose different objectives compared to treating the condition in younger patients. Some drugs may be less suitable for elderly patients, and treatment plans will almost certainly have to be adjusted.

Treating geriatrics with diabetes requires the caregiver to take a multidisciplinary role. The goals should always be the reduction of diabetes-related complications. Many older people with diabetes are under treated.

Will diabetes treatment vary between each person?

Just like in younger patients, each individual case of diabetes should be treated independently. Elderly patients who have diabetes should be given an assessment and a treatment plan worked out to suit their needs and lifestyles.

Remember, it is advisable to discuss diabetes with your doctor or medical practitioner to develop a plan specific to your requirements and needs.