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Updated 21 July 2014

Diabetes management in the elderly

Managing diabetes is not easy, whether you are young or old. It is always difficult to change your lifestyle – more so if you have done things in a particular way for years.

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Managing diabetes is not easy, whether you are young or old. It is always difficult to change your lifestyle in any way - more so if you have done things in a particular way for many years.

But managing diabetes well can really go a long way to ensuring a healthier life in elderly diabetics. Uncontrolled blood glucose levels compound conditions such as high blood pressure, circulatory disorders, heart problems and eye problems - conditions often found in the elderly.

There are four areas of diabetes management : exercise, diet, blood glucose control and medication. Sticking to the following tips can make your life a lot easier.

Here are a few tips to help manage your diabetes:

Get a move on

All diabetics, whether young or old, need regular, fairly moderate exercise. It is much better to walk for half an hour every day than to do a once-a-week marathon gym session. The latter could in fact be harmful to your health.

Feet first

Choose the type of exercise that isn’t hard on your feet. Blisters, cuts and foot infections can spell serious trouble for diabetics. Swimming is good, as is cycling, depending on how sprightly you feel, or even gentle walking.

If the shoe fits

Make sure that your shoes fit properly and that they are comfortable to walk in. The last thing a diabetic wants is an injury from an ill-fitting shoe. Infections or cuts in your feet can start off a chain reaction that can have serious longterm effects. Invest in well-fitting shoes, even if they are costly.

Get a grip on your weight

Remember that diabetes cannot be cured, but that you can control it very effectively. Having the correct weight goes a long way to making this condition manageable. Consult your doctor about healthy weight loss diets. Remember that a crash diet can be fatal.

Do it three times a day

Never skip a meal or eat much later than usual. This can cause your blood sugar levels to drop and cause many unpleasant symptoms, the worst of which is a diabetic coma. Small regular meals are preferable to one large one.

Become a snackpacker

To correct low blood sugar, you should always carry something sweet with you wherever you go. Raisins, fruit juice, soda (not sugar-free) or hard sweets like toffees, are good for this purpose. All of these should be taken in small amounts.

Fat happens

Beware the hidden fats in things like sauces, stews, fried foods and pastries. Get into a habit of using low-fat or fat-free dairy products and vegetable oil spray rather than butter or margarine.

Don’t hit the bottle

One glass of wine or one beer a day shouldn’t do much harm, but remember that alcohol is generally high in sugar content and that having one too many can play havoc with your blood sugar levels. A tot of whiskey is probably the best as it contains no sugar. Before you have any alcoholic drinks, you should speak to your doctor.

Go nuts with fruits and vegetables

Eat lots of fresh fruit and vegetables. When cooking vegetables, grill them and sprinkle them with spices, vinegar, garlic or lemon juice. These add almost no fat or calories to the meal. Strawberries and bananas are both good fruits to choose.

Go the wholewheat way

Learn to eat lots of grains and wholewheat bread and carbohydrates in general. Stay away from fried starches such as potato chips.

Be a factfinder

Knowing as much as possible is your best defence against diabetes. Find out how your body uses food and what role insulin plays in this process.

Watch out for your eyes

Diabetes is the leading cause of blindness in people between 25 – 74. Diabetic retinopathy is a disease affecting the blood vessels in the retina (the back layer of the eye). Have regular eye tests and stick to your medication, diet and exercise routine.

Don’t leave home without it

If you have Type 1 Diabetes and are insulin dependent, you need to have insulin injections with you at all times - even if you are just going down the road to buy a loaf of bread. You also need to show friends and family how to inject you if you should become unable to do it yourself. Always have spare supplies if you are traveling.

Become tagged

Wearing a medic alert bracelet is essential for all diabetics - it could save your life if you are in an accident of some sort or if you go into a diabetic coma.

Become a regular with your GP

See the doctor frequently so that your condition can be monitored regularly. There is no point in taking chances with your health. You need to be on the lookout for any worsening symptoms that could point to hypertension, heart problems, or circulatory disorders.

The test is best

Invest in a blood glucose monitor, a test strip and a lancing device. Use it regularly and you will always know how your body is coping. In this way you can always adjust your diet or your medication (with your doctor’s permission of course) before things get critical. In the case of diabetes, prevention is always better than crisis management, as it prevents complications on the long run.

Chew on this

Have your teeth checked regularly. Diabetes can compromise your immune system, which fights off viruses and bacteria. Your mouth is a haven for bacteria and hence your teeth are at risk if you are diabetic.

Go GI, Jane

The Glycaemic Index (GI) involves a ranking of foods based on their immediate effect on blood glucose levels. Foods with a low GI (“slow-release”) do not overstimulate the pancreas to produce too much insulin. These foods include low-fat yoghurt, cereals, whole-wheat bread, fruit and vegetables and should be included in your diet regularly. Keep these in mind constantly.

What goes round need not come round

Many diabetics are very susceptible to viral infections, so have those flu shots before the winter sets in. Immunisations against other infections doing the rounds are also advised. Don’t ignore that nagging cold that won’t go away - take it to the doctor.

Chill out

High stress levels can cause hyperglycaemia (high blood sugar). A healthy diet and regular exercise can help to control this, but it might be wise to see a therapist and do some yoga classes in addition to this. Learn some de-stressing techniques.

Become your own lifesaver

Don’t forget that you are dealing with a potentially dangerous disease here. Take your medication as instructed and don’t skip meals or eat the wrong type of foods. By sticking to these things daily, you can control the disease instead of letting it control you.

Danger zone - sample only

Foods that have a very high sugar or fat content must be avoided. Only very small amounts of foodstuffs like nuts, chocolates, fried chicken, oily fish, shellfish and creamy desserts and cakes should be eaten.

Listen to your body

Learn to read the signs of dangerous blood sugar fluctuations - these include excessive thirst, frequent urination, extreme hunger, weight loss, inexplicable moodiness, weakness and fatigue, nausea (type 1 diabetes) and in the case of type 2, all of the previous symptoms, as well as skin, gum and bladder infections, blurred vision, itching and tingling in the hands and feet.

Where there is smoke

Smoking generally increases your blood pressure. If you are diabetic, this could mean long term circulatory problems could become more likely. Take steps to quit, however difficult it might be. - Health24, updated February 2010)

 

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Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.

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