Challenge #1: Addressing obstacles specific to older adults with type 2 diabetes
There's no denying that people with type 2 diabetes face significant hurdles to keeping the disorder under control. These include:
- Increased insulin resistance. Insulin resistance, or the body's inability to respond to and use the insulin it produces, tends to be more of a problem as a person ages, even if he isn't particularly overweight or inactive.
- Recognizing symptoms. Older people with diabetes often don't recognize symptoms of the disease. For example, one sign of this disorder is increased thirst, but older people tend to lose their ability to recognize this sensation. Or they may just chalk up frequent urination, another warning sign, to advanced age.
- Contradictory symptoms. When a person does have signs of type 2 diabetes, they may be confusing. For instance, a patient may feel tired, hungry, and shaky, all typical red flags for hypoglycemia or low blood sugar, but a test of his blood glucose may reveal that he's actually experiencing hyperglycemia or high blood sugar.
- Complications. Older people with diabetes often aren't diagnosed with the disease until a complication linked to this condition, such as vision loss, nerve damage, kidney failure, or cardiovascular disease, emerges -- which suggests someone may have had the disorder for several years.
- Memory loss. Coping with diabetes requires a reasonably high level of cognitive or mental function, given the need to follow a treatment plan that includes diet, exercise, and medication components as well as blood sugar testing and other self-care measures. Those with diabetes have a higher incidence of both dementia and Alzheimer's disease, making it even harder for them to perform multiple, complex tasks. Even garden-variety memory loss associated with aging can impact how well a person deals with diabetes.
Potential solutions:
- Blood sugar monitoring. Encourage the person in your care to test regularly and often so he has a good sense of his blood sugar numbers, which takes the guesswork out of whether or not he's in his target range -- regardless of symptoms.
- Routine checkups. Make sure he has regular checkups and visits with specialists to address any diabetes-related complications he may have.
- Tracking sheets. Help him set up simple systems for monitoring his blood glucose control, such as a preformatted sheet or logbook for recording his test results, as well as a similar sheet for tracking medications. (The American Society of Consultant Pharmacists offers a downloadable medication record form.)
- Help from professionals. If you're unsure about his ability to practice self-care, discuss any mental impairment issues with his primary diabetes healthcare provider. It's helpful if you provide specific examples of the difficulties he faces in managing his disease.
