Canadians living with diabetes face new health risks as they get older. Learn what you need to know about aging with diabetes – and how to stay as healthy as possible.
Highlights:
- Create a customized diabetes care plan to help prevent health complications
- Learn which diabetes medications help limit the risk of hypoglycemia (low blood sugar)
- Learn how diabetes affects brain health, memory and cognitive function as you get older
- Protect your eyes, feet and kidneys with routine screening and better blood sugar management
- Use exercise and healthy eating to maintain strength, mobility and healthy aging
How does the risk of diabetes-related problems change as you age?
Diabetes impacts people of all ages, but there are new complications to think about as you get older.
When you age, your body slows down. Your heart and other organs are more vulnerable to damage and disease. You may be diagnosed with other health conditions, along with diabetes. You are also more likely to become less active and put on weight.
These changes – and others – can make managing diabetes more difficult. It can also lead to health complications associated with the disease, such as nerve damage, vision loss and kidney problems.
Why does blood sugar regulation become more challenging with aging?
As our bodies age, blood sugar levels become harder to control and keep within the target range. Along with blood sugar spikes, seniors are also at risk for having low blood sugar. This is known as hypoglycemia.
The reason? People over 65 do not produce as much of the hormone glucagon, which is responsible for increasing blood sugar levels. So not only do older people with diabetes need to watch for high blood sugar levels, but levels that are too low are also a serious concern. Reduced mental activity may cause individuals to be unable to recognize the symptoms of hypoglycemia, and physical impairment may prevent individuals from being able to properly treat their low blood sugar. Often the signs of hypoglycemia are nonspecific (sweating, dizziness, confusion, visual disturbances) and are mistaken for neurological symptoms or dementia. In more severe cases, it may lead to falls, cognitive decline, and loss of consciousness.
To reduce your risk of hypoglycemia, avoid skipping meals and keep fast-acting carbs nearby to raise your blood sugar quickly. Also, learn to identify the first symptoms so you can act quickly to bring blood sugar levels back up. Your diabetes healthcare team may adjust your blood sugar targets and your medications to reduce the risk of hypoglycemia.
Which diabetes complications become more common later in life?
As you live longer with diabetes, you are more at risk of developing complications. These include:
- Kidney disease
- Heart disease
- Nerve damage
- Vision loss
It is important to have a diabetes treatment plan tailored to your age, to help prevent damage to your organs, nerves and blood vessels from diabetes. Speak with your diabetes healthcare provider who will provide you with an individualized plan for screening and management of diabetes complications.
How does aging affect the use of medications?
As you get older, your kidneys and liver may not work as well. This may lead to problems with your body processing medications as it should. Seniors may find their diabetes medications do not work as well and they used to, and they may experience more drug side effects. In particular, sulphonylureas (e.g. glyburide) and insulin carry a high risk of hypoglycemia, requiring cautious use, individualized targets, and frequent monitoring to avoid serious adverse events.
You may develop other health problems as you get older that require medication to control. Be aware of possible drug interactions and side effects.
What is the connection between diabetes, aging, and cognitive health?
Researchers have found a strong link between diabetes and brain aging. Individuals living with diabetes are more likely to experience cognitive decline and dementia than people without diabetes. In some studies, the risk is 1.5 to 2 times more likely.
The reason for this is that over time diabetes can damage blood vessels in the brain. This can impact memory, focus, and problem-solving.
To maintain brain health in your older years, try to keep blood sugar levels in your target range as much as possible. Also, include plenty of fruits and vegetables as well as whole grains in your diet, and exercise regularly. The Brain Health Food Guide offers some guidance for a balanced diet to help improve cognitive function and prevent dementia risk.
Which preventive screenings become especially important as you age with diabetes?
It is important to have your blood pressure checked at every doctor visit, or frequently at home or at your pharmacy.
To check your blood sugar control, test your blood sugar at home regularly and ask your healthcare provider to check your A1C every 3-6 months.
You should book a full eye exam at least every year to check for retinopathy and/or macular edema.
Also, check your feet daily and see a foot doctor every year to look for nerve damage, infections, and ulcers.
People with diabetes are at high risk of developing kidney disease. There are no symptoms for early kidney damage, so it is vital to test your kidney function as you get older.
How can diabetes care be adapted to support healthy aging?
Speak with your diabetes doctor about a personalized care plan for aging with diabetes. This plan should be designed to help you adapt to the new risks you face. Be sure this plan includes:
- Blood sugar management with regular A1C tests
- Diabetes medications that reduce the risk of hypoglycemia
- A meal plan that centres on fruits, vegetables, and healthy proteins
- Low impact training to maintain muscle and heart health
- A strategy to balance multiple health conditions and unwanted drug interactions
Conclusion
The risks of diabetes change as you get older and your body starts to slow down. A customized care plan that includes diet, exercise and regular medical screenings will help you stay healthier.
