What to Know About Diabetes

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Diabetes

Top Takeaways

  1. Proper medication management, diet and exercise can be highly beneficial for senior loved ones managing Type 1 or Type 2 diabetes.
  2. Annual medical checkups and daily foot checks are essential to healthy diabetes management. 
  3. Diabetic friendly diets can still include your loved ones favorite foods. 
  4. Seeking help from a home care provider can help reduce care stress related to managing your loved ones diabetes safely and successfully. 



Intro 

 

Approximately 27% (or about 14.3 million) of American adults over the age of 65 have diabetes, and another 1.5 million Americans are diagnosed with diabetes each year. 

Diabetes may affect millions of people, but many of them continue to live happy and active lives regardless of their diagnosis. In many cases, a family member or loved one acts as a caretaker at home to help ensure their loved one remains safe and follows advice from their medical provider. This may include helping with medications, diet, exercise, and ensuring their loved one gets to regular appointments.

Being a caretaker can be challenging. However, with the appropriate information and a list of tips and tricks, you can help your loved one with diabetes maintain a happy, healthy, and active lifestyle.



Types of Diabetes

 

Diabetes is broken down into three main Types. The most common is Type 2 diabetes. 

  • Type 1 Diabetes: Type 1 diabetes is likely related to an autoimmune disorder that causes the body to stop making insulin. Type 1 is usually diagnosed in younger people and requires daily insulin. 
  • Type 2 Diabetes: Type 2 diabetes occurs when the body is not producing enough insulin to maintain blood sugar levels. Approximately 90 to 95% of people with diabetes have Type 2 diabetes. It is generally diagnosed in adults but can be prevented or delayed with healthy lifestyle changes and a healthy diet. In many cases, diet and exercise are enough to manage Type 2 diabetes, but diabetes medications or insulin therapy may be necessary for some. 



Insulin and Insulin Management

A significant portion of diabetes care and management centers on insulin. For seniors with Type 1 diabetes, daily insulin is needed to maintain healthy blood glucose levels. Insulin can be administered via injection or through an insulin pump. 

  • With a pump, insulin is administered at regular intervals and doses throughout the day. 
  • With injections, it is necessary to self-administer insulin at specific times each day as prescribed by your doctor. 


If your loved one uses insulin injections to manage blood glucose, there are a few important tips to remember: 

  • Make sure the injection site and your (or loved ones) hands are clean before injecting. This is vital to preventing infection. 
  • Rotating injection sites helps to reduce bruising and prevent lumps of fat deposits under the skin. 
  • Insulin should be injected at the same time of day in the same general location on the body each day. 
  • Insulin enters the blood at different rates depending on the injection site. The fastest rate of entry is from the stomach and the slowest is the buttocks. 
  • Different Types of insulin may be used as part of your treatment plan. 

 

NOTE: Developing the most effective insulin regimen may require trial and error. It is vital to work with your senior loved ones primary care provider to find the best insulin, injection site and injection times. 



Helping Your Loved One Avoid Complications

 

Once your senior loved one is diagnosed with diabetes, regardless of Type, there is no cure. However, you can do things as a caretaker to help reduce their risk of diabetes complications. Such as:

  • Encourage activity
  • Monitor blood sugar levels daily or as often as recommended by their doctor. 
  • Use caution with carbs in their diet
  • Help them manage stress
  • Reduce or eliminate salt
  • Encourage weight loss (if necessary) 
  • Ensure they get enough sleep
  • Get medical attention for cuts, wounds, and bruises
  • Help them quit smoking
  • Ensure they follow a balanced, diabetic-friendly diet
  • Be sure they go to regular check-ups with their doctor



What Does a Diabetic-Friendly Diet Look Like? 

 

Many people worry about what their diet will be after learning they have diabetes. Seniors often wonder what they can eat and what they should steer clear of. As their caregiver, you can help them maintain their diet and still enjoy their favorite foods when it is appropriate. 


A diabetic-friendly diet consists of a variety of healthy foods from all food groups. Your loved one’s  primary care provider will work with you to help determine the right amount of daily caloric intake for their specific needs. Examples of the food groups and diabetic-friendly options are below: 

  • Vegetables such as carrots, peppers, tomatoes, greens, corn, green peas, carrots, and broccoli. 
  • Fruits such as berries, apples, melons, bananas, grapes, and oranges.
  • Protein such as lean meats, eggs, nuts, eggs, fish, chicken or turkey (skinless), dried beans, and meat substitutes. 
  • Grains (focus on whole grains) such as oats, barley, wheat, cornmeal, and quinoa. 
  • Dairy (nonfat or low fat) products including milk or lactose, cheese, and yogurt. 


It is important to limit foods that are high in saturated or trans fats, sodium, and added sugars or sweets. A few examples of foods to avoid include:

  • Pasta, white rice or pasta
  • Yogurt flavored with fruit
  • Beverages with sugar sweeteners
  • Flavored coffee beverages
  • Maple syrup, honey or agave 
  • Pre-packaged snack foods such as pretzels or graham crackers
  • Fruit juices
  • Fried foods such as french fries



Regular Exercise Can Help Manage Blood Sugar Levels

 

A regular routine of healthy activity can help your loved one in many ways. Being active helps maintain blood sugar levels and helps with weight loss. It can alsoo help reduce the risk of other physical and mental health concerns that contribute to disease onset or progression in seniors. 


Even a moderate exercise,  such as walking, helps to increase heart and breathing rates. This helps your muscles use more glucose (the sugar that is present in the blood), which can help to lower blood sugar levels. 


If your loved one’s doctor says it is OK, encourage a healthy amount of activity each week. Examples of excellent activities you can do together include:

  • Walking
  • Cycling
  • Team Sports such as tennis 
  • Swimming
  • Lightweight training
  • Aerobic dance such as Zumba or ballroom dancing
  • Exercises using resistance bands
  • Calisthenics (exercises that use your own bodyweight) 
  • Yoga
  • Pilates



Regular Medical Appointments Are A Vital Part of Care

 

Diabetic care requires regular medical appointments with primary care providers and specialists. If your loved one is successfully managing their diabetes, they will require visits to their primary care provider every six months. If possible, attend their appointment with them so you are aware of any important information or treatment needs they have. 


People with diabetes also see a range of specialists who complement general medical care. Below are the most common:

  1. Endocrinologist

    In addition to a Primary Care Provider, your loved one may have regular appointments with an endocrinologist, a Type of provider that specializes in diabetes care. An endocrinologist will:

    • Help a person with Type 1 diabetes manage their diabetic treatment plan. 
    • Help someone with Type 2 diabetes manage their treatment if they’re struggling to do so without medical intervention

  2. Ophthalmologist

    Vision complications are a common challenge among diabetics. Eye problems including glaucoma, cataracts and diabetic retinopathy (retina damage) can occur without regular eye appointments. The American Diabetes Association recommends:

    • Annual eye dilation and comprehensive exams for people with Type 1 Diabetes starting five years after diagnosis 
    • Similar exams for people with Type 2 Diabetes beginning at the time of diagnosis. 

  3. Podiatrist

    Nerve damage and blood flow problems to the feet can lead to difficulties with circulation and sensation. Diseases that affect how the blood flows to the feet are common among diabetics. Someone with diabetes may also have problems healing injuries to the feet such as blisters, cuts, or trauma injuries. Annual visits to the foot doctor can help prevent serious infections that can lead to serious medical complications. 

    • It is vital to continue checking your loved ones' feet daily in addition to regular medical checks. 
    • When helping check their feet look for ingrown toenails, cuts, sores, and blisters. 
    • Also, check for temperature changes or color changes, as this may indicate injury or circulation problems. 



Assist with Medication Management

 

Your loved ones medication list will vary depending on whether they have Type 1 or Type 2 Diabetes. 


With Type 1 diabetes, daily insulin is required to manage blood sugar levels because the body does not make insulin on its own. The Type of insulin your loved one needs will depend on how far reduced their insulin levels are. They may need:

  • Short-acting insulin (5-15 minute onset/4-5 hour duration)
  • Rapid acting insulin (20-60 minute onset/8-10 hour duration)
  • Intermediate-acting insulin (1-2 hour onset/10-20 hour duration)
  • Long-acting insulin (1-2 hour onset/up to 24 hour duration)
  • Combination insulin


Someone with Type 1 Diabetes may also need medications to slow the speed at which the stomach empties. These medications, called Amylinomimetic drugs, may also help with appetite reduction and dietary management. 


With Type 2 Diabetes
the body still makes insulin but struggles to use it properly. Most of the medications used by people with Type 2 diabetes are oral medication however, some individuals may need insulin injections as well. Examples of typical Type 2 diabetes medications include:

  • Alpha-glucosidase inhibitors-medications that help the body break down table sugars and foods that contain a lot of starch helping to lower blood sugar levels. 
  • Biguanides-medications that decrease how much sugar the liver makes. 
  • Dipeptidyl peptidase-4 (DPP-4) inhibitors-medications that help the body continue to make insulin.
  • Glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists)-medications that increase B-cell growth and increase how much insulin the body uses. They may also help reduce appetite and slow stomach emptying. 
  • Meglitinides-medications that help the body release insulin. 
  • Sulfonylureas-medications that help the body make more insulin. 


Depending on your loved ones specific needs their medical provider may prescribe a combination of these medications and others to help manage symptoms. Unfortunately, managing a regular medication regimen with multiple medications can be confusing. It can help to have the assistance of a caregiver to ensure medications are taken safely and properly. 


Get Help from Their Medical Provider or a Home Care Aid if Needed

Successfully managing diabetes requires routine and careful monitoring. A home care aid can assist your loved one with managing their diabetes. Many care aids can help with blood sugar checks, provide reminders to take medications, assist with cooking and help with dietary management. They can also provide supervision and guidance necessary for your loved one to exercise and be active safely. Depending on the care aid and their licensing they may also be able to assist with medication administration. 





Anisha Rao, MPP

Anisha Rao, MPP is a Certified Healthcare Professional and Consultant, with experience in Chronic Diseases, Chronic pain, and Diabetes Self-Management. She's also worked with non-profits, public health agencies, as well as senior living providers and rehabs.