8 steps to manage your diabetes for life
Increased insulin resistance and being on multiple medications are two serious factors that need to be considered and constantly monitored as part of your diabetes care plan.
Despite these and other changes which affect diabetes, there are certainly ways you can stay healthy and full of vitality in your later years. Diabetes educators from Diabetes NSW & ACT in Australia have the following advice to offer those who are living with diabetes, as well as those who are looking for tips on how to take care of themselves through the ageing process.
1. How to identify whether your symptoms are from diabetes or other ailments associated with ageing
It can sometimes be difficult to tell the difference between symptoms caused by diabetes and those that are part of the ageing process. For example, when you were younger and your blood glucose levels were high, you may have felt thirsty. As you get older, you may not experience the same sensation of thirst when you have high blood glucose levels and unknowingly become dehydrated. Aim to drink at least eight glasses of fluid a day, this can include tea, milk and soup.
2. The blood glucose targets you had when you were younger may no longer be safe for you as you age
If you are frail, or if you take other medicines or have other health problems, you may be at greater risk of hypoglycaemia (‘hypo’) and falls. Once you turn 65, ask your doctor to review your blood glucose targets regularly.
3. Growing older can add extra risk factors which could lead to a hypo
Risk factors include having a poor appetite, being on four or more medications, or having kidney disease or other illnesses or conditions. You may find that your hypo warning signs change or become less obvious as you get older. You may just feel tired or confused or you may feel nothing at all. If you think your warning signs have changed, please discuss this with your doctor or diabetes educator. Together you will be able to work on strategies to identify a hypo.
4. The way your body uses medicines changes with age, and medications can work differently if you have a poor appetite, miss a meal or become less active
If you are concerned about the number of medicines you are taking and how they interact, ask your doctor to arrange a Home Medicines Review. A pharmacist will visit you at home and go through the medicines you take and your daily routine. The Home Medicines Review will provide your GP with recommendations in line with your lifestyle routines and health conditions and your GP will work with you on any necessary adjustments.
5. Some people worry about their memory and ability to think clearly as they age
For most people, thinking and memory stays relatively intact in later years. However, if you or your family notice that you are a having problem remembering recent events or thinking clearly, let your doctor know. All people with diabetes over the age of 65 should have their memory checked by their doctor once a year.
Tip: If you are worried about remembering when and how often to take your medications, there are tools to help, such as setting an alarm or requesting your medications be packaged into a blister pack, clearly divided into separate doses for different times.
6. As you get older, you have a higher risk of falls
Having diabetes further increases that risk because you may experience hypos or hyperglycaemia, or your diabetes may have affected your vision, balance or the feeling in your feet. You are also more likely to be on multiple medications, which can increase your risk of falls. It is important to let your doctor know if you are worried about falling or if you have a fall, even if you don’t hurt yourself.
Tip: If you are at risk of falling, consider getting a personal medical alarm to wear around your neck. The alarm can be used to alert a family member or a monitoring service in a medical emergency. If you live alone, a personal alarm will help you to feel safe and stay independent in your own home.
7. It can become a challenge to stay nourished and maintain healthy eating habits as you age.
Talk to your health care team if you:
- Lose your appetite.
- Are losing weight without trying.
- Experience incontinence or constipation.
- Have trouble with a sore mouth or gums, your teeth, dentures or swallowing.
- Have trouble grocery shopping or cooking.
8. The ageing process and the complications of diabetes can result in physical limitations that impact your life
You may experience vision problems, hearing loss, have less physical energy and flexibility, or be in pain. As you get older your airways can get less stable and, if you are prone to sleep apnoea and snoring, it can become worse and impact your sleep and diabetes management if not treated.
If you have had diabetes for some time, you may be under the care of several different health care providers and take multiple medications, making it a challenge to find a balance. It’s important you have regular check-ups and to make sure members of your health team are talking to one another about your care. Usually your GP will act as the central point of care. Don’t be afraid to ask questions to keep informed.
Tip: It’s always a good idea to take a pen and notepad to your appointments so you can make notes. It’s easy to miss things, or forget what was said… whatever your age!
There’s no such thing as a fountain of youth, but by staying physically active you can counteract some of the effects of ageing. You are never too old to start exercising and any increase in activity will make a difference to your health and wellbeing. Talk to your doctor first, then start off slowly and build up.
Despite some of the challenges, the ageing process can and should be a positive experience. It is a time of significant change but it may also be a time of greater freedom, maturity, wisdom and resilience. It is important to still stay connected with people and to do the things you enjoy as it allows you to continue to feel good and have a sense of control as you age.
For more advice, head to https://diabetesnsw.com.au/.