Diabetes in older people--a disease you can manage.

Diabetes is a serious disease. People get diabetes when their blood glucose level, sometimes called blood sugar, is too high. Diabetes can lead to dangerous health problems, such as having a heart attack or a stroke. The good news is that there are things you can do to take control of diabetes and prevent its problems. And, if you are worried about getting diabetes, there are things you can do to lower your risk.

What Is Diabetes?

Our bodies change the food we eat into glucose. Insulin helps turn glucose into energy that "fuels" our cells. If you have diabetes, your body does not make insulin, does not use insulin the right way, or both. That means there is too much glucose in the blood. Doctors who specialize in taking care of people with diabetes are called endocrinologists.

Types of Diabetes

There are two kinds of diabetes. In type 1 diabetes, the body does not make insulin. It develops most often in children and young adults but can happen at any age.

Type 2 diabetes is the most common kind. You may have heard it called adult-on-set diabetes. In type 2 diabetes, the body makes insulin but doesn't use it the right way. Your chance of getting type 2 diabetes is higher if you are overweight, inactive, and/or have a family history of diabetes.

Symptoms

Sometimes people with type 2 diabetes don't even know they have it. People with untreated diabetes often feel tired, hungry, or thirsty. They may lose weight, urinate often, or have trouble with their eyes, such as blurred vision. They may also get skin infections or heal slowly from cuts and bruises. See your doctor right away if you have one or more of these symptoms.

Diabetes can cause problems with your heart, blood vessels, eyes, kidneys, nerves, teeth, and gums. People with type 2 diabetes also may be more at risk for Alzheimer's disease. Researchers are studying this connection now.

There is a lot we don't know about diabetes and how best to manage it. But there is a lot we do know. For example, we know that careful control of your weight, glucose, blood pressure, and cholesterol can help prevent or delay diabetes and problems caused by it. Exercise can also help.

Pre-diabetes

Many people have "pre-diabetes." This means their glucose levels are higher than normal but not high enough to be called diabetes. People with prediabetes are at high risk for developing type 2 diabetes, heart disease, and stroke.

Pre-diabetes is a serious problem, but there are things you can do. For example, losing weight by exercising and eating healthy foods can work to prevent or delay diabetes in older adults.

Tests for Diabetes

If you have symptoms of diabetes, your doctor will check your blood glucose levels. The most common test for diabetes is called the fasting glucose test.

This blood test measures your glucose after you have nothing to eat or drink (that's called fasting) for at least 8 hours, usually overnight. Another blood test, called the oral glucose tolerance test, checks your glucose after fasting overnight and then again 2 hours after you have a sugary drink. Your doctor may want you to have the test for diabetes twice to make sure of the results.

Managing Diabetes

When you have diabetes, your body does not use or make insulin properly. Your doctor may prescribe pills, insulin, other injectable medicines, or a combination of these to help control your blood glucose levels. Insulin can be taken by shots/injections, with an insulin pump, or even inhaled.

In addition, you can keep control of your diabetes by:

* Tracking your glucose levels. Very high glucose levels or very low glucose levels (called hypoglycemia) are dangerous health emergencies. Talk to your doctor about how you can check your glucose levels at home.

* Making healthy food choices. Learn how different foods affect your glucose levels. Think about foods you like that will also help you lose weight. Let your doctor know if you want help with meal planning.

* Getting exercise. Daily exercise can help improve glucose levels in older people with diabetes. Ask your doctor to help you plan an exercise program.

* Keeping track of how you are doing. Talk to your doctor about how well your diabetes care plan is working. Make sure you know how often you need to check your glucose levels.

Your doctor may want you to see other health care providers who can help you manage some of the extra problems caused by diabetes. He or she can also give you a schedule for tests you may need. Talk to your doctor about what you can do to stay healthy. Here are some things to keep in mind:

* Have yearly eye exams. Finding and treating eye problems early may keep your eyes healthy.

* Check your kidneys yearly. Diabetes can be hard on your kidneys. A urine and blood test will show if your kidneys are okay.

* Get flu shots and a pneumonia vaccine. A yearly flu shot will help keep you healthy. If you're over 65, make sure you have had a pneumonia shot. Talk with your doctor to see if you should get another one.

* Check your cholesterol. At least once a year, get a blood test to check your cholesterol as well as your triglyceride levels. High levels may increase your risk for heart problems.

* Care for your teeth and gums. Your teeth and gums need to be checked by a dentist twice a year to avoid serious problems.

* Find out your average blood glucose level. At least twice a year, get a blood test called the A1C test. The result will tell you your average glucose level for the past 2 to 3 months.

* Protect your skin. Keep your skin clean and use skin softeners for dryness. Take care of minor cuts and bruises to prevent infections.

* Look at your feet. Take time to look at your feet every day for any red patches. If you have sores, blisters, breaks in the skin, infections, or build-up of calluses, see your doctor. Your doctor may also tell you to see a foot doctor called a podiatrist.

* Watch your blood pressure. Get your blood pressure checked regularly.

Medicare Can Help

Medicare will pay to help you learn how to care for your diabetes. It will also pay for some diabetes tests, supplies, special shoes, foot exams, eye tests, and help with meal planning.

For more information about what Medicare covers, call 800-MEDICARE (800-633-4227, toll free) or visit their website, www.medicare.gov/Health/Diabetes.asp.

For More Information

Here are some helpful Federal and non-Federal resources:

American Diabetes Association 

1701 North Beauregard Street

Alexandria, VA 22311

800-DIABETES (800-342-2383, toll free)

www.diabetes.org

National Diabetes Education Program One Diabetes Way

Bethesda, MD 20892-3560

800-438-5383 (toll free)

www.ndep.nih.gov

National Diabetes Information Clearinghouse (NDIC)

National Institute of Diabetes and

Digestive and Kidney Diseases

One Information Way

Bethesda, MD 20892-3560

800-860-8747 (toll free)

www.diabetes.niddk.nih.gov

For more information on health and aging, contact:

National Institute on Aging Information Center

P.O. Box 8057

Gaithersburg, MD 20898-8057

800-222-2225 (toll free)

800-222-4225 (TTY/toll free)

To order publications (in English or Spanish) or sign up for regular email alerts, visit www.nia.nih.gov/HealthInformation.

Visit NIHSeniorHealth.gov (www.nihseniorhealth.gov), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website has health information for older adults. There are also special features that make it simple to use. For example, you can click on a button to have the text read out loud or to make the type larger.

National Institute on Aging

U.S. Department of Health and Human Services Public Health Service National Institutes of Health

July 2007