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Diabetes & Caregiving: A Q&A with Dr. Nuha El Sayed

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How does diabetes change with age?

This question does not have a simple answer. People can develop type 1 or type 2 diabetes at any age and in general, the longer one has diabetes, the greater the likelihood of complications. However, it is important to note that type 2 diabetes can be prevented, and if people develop any type of diabetes, working closely with their healthcare team to prevent complications is key. 


Talk about diagnosis as an older adult. How does that impact life?

Older adults with diabetes have unique challenges. Diabetes affects many aspects of life. They may need more support from their caregivers and families because they are unable to do things for themselves. They need to pay more attention to nutrition and activity levels, which can change over time. They will also need more medical visits (eye specialists, diabetes care and education, cardiologists, podiatrists, nephrologists...etc.) 


What are specific health issues to watch for?

I would watch for increased risk of falls (from low glucose i.e. hypoglycemia), medication conflicts (interactions) and/ or what we call polypharmacy, dexterity/vision and hearing loss, memory and loss of function, as well as, various psychological and behavioral issues including depression.


What about exercise?

Exercise should always be encouraged, but safely and under supervision if needed. Talking with your loved one's healthcare team about what types of exercise would be best for them to take on physically and to help manage their diabetes is a great place to start.  


Does medication management change?

Yes, sometimes it makes sense to simplify regimens and make sure medication types and doses are appropriate and safe for an older person with diabetes. At different stages of life, your loved one may just need different things and so changing their medication could play a part in that. Age and activity levels will contribute as well. 


What other conditions can occur in a diabetic?

Complications of diabetes include: heart disease, stroke, kidney disease, vision loss, nerve damage and limb loss. Following up and actively participating in diabetes management is critical to prevent these complications. Knowing the signs and risks of these will help your loved one and their healthcare team stay on top of their condition and hopefully prevent further complications. 


What should be monitored beyond glucose levels? (Cholesterol, BP, teeth & gums, feet, etc.)

All of the above. For people with diabetes, we monitor glucose levels, cholesterol levels, blood pressure and weight. We perform various tests and exams to screen for kidney disease, and foot issues. We also make sure people are keeping up with their visits to eye specialists, podiatrists, dentists and so on. Type 1 and type 2 diabetes can often be a lifelong diagnosis, so staying on top of all aspects of your loved one's health will help them stay at their healthiest and prevent further complications as they age. 


Dr. Nuha El Sayed, VP of Healthcare Improvement at the American Diabetes Association

Dr. Nuha El Sayed MD, MMSc began her work at the American Diabetes Association in 2021 serving as Vice President of Health Care Improvement. She focuses on those at high risk to develop diabetes, type 1 and type 2 diabetes with an emphasis on lifestyle medicine, weight management, complications prevention and the use of technology in diabetes care. 

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