The Elderly And Diabetes: Everything You Need To Know
According to the American Diabetes Association, as we get older, our chances of getting Type 2 diabetes increases. They claim that one in four Americans over the age of 60 has diabetes.1 Carolyn contacted The Diabetes Council… When Carolyn contacted TheDiabetesCouncil, she was concerned about her mother who is elderly and is living with diabetes. She didn’t know much about her medications, or how they might interact with her other medications. She was worried that her mother’s low blood sugar while she was home alone may be related to her worsening memory. In addition to referring Carolyn to a local Certified Diabetes Educator, we, at TheDiabetesCouncil, decided to write a guide for the elderly with diabetes that people like Carolyn could refer to. In the following article we will explore many different guidelines and recommendations, along with nutritional, activity, pharmaceutical, and financial and estate planning considerations. Those are just a few of the issues that we will touch on related to the elderly with diabetes. So let’s get started with some general and medication considerations first… General guidelines for the elderly with diabetes The following are some general guidelines to consider when treating the elderly with diabetes: Recommendation for the Eldery with Diabetes Depression screening in the elderly population with diabetes is of great importance, as elderly patients with diabetes experience more isolation, less support, and more feeling of hopelessness Avoiding low blood sugar is of paramount importance, and A1C and blood sugar goals should be adjusted, along with careful pharmaceutical management The elderly with diabetes who are capable of activities of daily living without assistance, and who have no cognitive impairment should have A1 Continue reading >>
Are You At Risk For Diabetes?
Who Gets Diabetes and How to Manage It Diabetes is a metabolic disease that can lead to serious health complications if left untreated. Several factors, such as body weight, family history and race and ethnicity may increase your risk of diabetes. Diabetes can be effectively managed by exercising and eating a healthy diet. What is diabetes? Diabetes (medically known as diabetes mellitus) is a common, chronic disorder marked by elevated levels of blood glucose, or sugar. It occurs when your cells don’t respond appropriately to insulin (a hormone secreted by the pancreas), and when your pancreas can’t produce more insulin in response. Diabetes usually can’t be cured. Left untreated—or poorly managed—it can lead to serious long-term complications, including kidney failure, amputation, and blindness. Moreover, having diabetes increases your risk for cardiovascular disease, including heart attack and stroke. Your body and sugar To understand diabetes, it’s helpful to understand the basics of how your body metabolizes (breaks down) sugar. Most of the cells in your body need sugar as a source of energy. When you eat carbohydrates, such as a bowl of pasta or some vegetables, your digestive system breaks the carbohydrates down into simple sugars such as glucose, which travel into and through your bloodstream to nourish and energize cells. A key player in the breakdown of sugar is the pancreas, a fish-shaped gland behind your stomach and liver. The pancreas fills two roles. It produces enzymes that flow into the small intestine to help break down the nutrients in your food—proteins, carbohydrates, and fats—to provide sources of energy and building material for the body’s cells. It makes hormones that regulate the disposal of nutrients, including sugars. Cells in Continue reading >>
The Link Between Blood Sugar And Memory
Average Reading Time: 5 minutes and 14 seconds One in nine individuals over age 65 are estimated to be living with cognitive-related concerns, (1), adding up to 5.2 million Americans that are currently suffering. One in eight adults 60 years or older self-reported concerns of increased confusion or memory loss over their previous years – that’s potentially another 7 million Americans at risk! (2) In 2015, Australian researchers found that high-normal blood sugar levels are associated with increased risk of developing cognitive concerns later in life (age 60 and over). (3) These findings are supported by a study in the New England Journal of Medicine, where they found that fasting blood sugars just above 95mg/dL – still considered within the ‘normal’ range – may be associated with a significant risk in cognitive issues later in life. (14) In a 2011 report from the CDC, one-third of Americans are currently pre-diabetic, (3) putting 100 million Americans at significant risk for mental and cognitive concerns. To make matters worse, 90% of them – or 90 million Americans – are unaware they have pre-diabetes! (3) Moreover, many people don’t realize that you can eat healthy treats and still be in the pre-diabetic zone. Depressing, right? But this does not have to be you, and you can have a positive effect on helping your loved ones steer clear of the danger zone, too. Read on and learn how to change these odds before it is too late! Blood Sugar and Memory: Two Links to the Same End There are two basic theories linking elevated blood sugars to cognitive and mental clarity later in life: Theory 1: Insulin Resistance of the Brain Often, cognitive decline is due to a process by which excess amyloid plaque builds up in the brain, compromising brain function. While Continue reading >>
Aging Is Associated With Increased Hba1c Levels, Independently Of Glucose Levels And Insulin Resistance, And Also With Decreased Hba1c Diagnostic Specificity.
Abstract AIM: To determine whether using HbA1c for screening and management could be confounded by age differences, whether age effects can be explained by unrecognized diabetes and prediabetes, insulin resistance or postprandial hyperglycaemia, and whether the effects of aging have an impact on diagnostic accuracy. METHODS: We conducted a cross-sectional analysis in adults without known diabetes in the Screening for Impaired Glucose Tolerance (SIGT) study 2005-2008 (n=1573) and the National Health and Nutrition Examination Survey (NHANES) 2005-2006 (n=1184). RESULTS: Both glucose intolerance and HbA(1c) levels increased with age. In univariate analyses including all subjects, HbA(1c) levels increased by 0.93 mmol/mol (0.085%) per 10 years of age in the SIGT study and by 1.03 mmol/mol (0.094%) per 10 years in the NHANES; in both datasets, the HbA(1c) increase was 0.87 mmol/mol (0.08%) per 10 years in subjects without diabetes, and 0.76 mmol/mol (0.07%) per 10 years in subjects with normal glucose tolerance, all P<0.001. In multivariate analyses of subjects with normal glucose tolerance, the relationship between age and HbA(1c) remained significant (P<0.001) after adjustment for covariates including race, BMI, waist circumference, sagittal abdominal diameter, triglyceride/HDL ratio, and fasting and 2-h plasma glucose and other glucose levels, as assessed by an oral glucose tolerance test. In both datasets, the HbA(1c) of an 80-year-old individual with normal glucose tolerance would be 3.82 mmol/mol (0.35%) greater than that of a 30-year-old with normal glucose tolerance, a difference that is clinically significant. Moreover, the specificity of HbA(1c) -based diagnostic criteria for prediabetes decreased substantially with increasing age (P<0.0001). CONCLUSIONS: In two la Continue reading >>
- Ultraviolet Radiation Suppresses Obesity and Symptoms of Metabolic Syndrome Independently of Vitamin D in Mice Fed a High-Fat Diet
- Excessive fruit consumption during the second trimester is associated with increased likelihood of gestational diabetes mellitus: a prospective study
- Cellular markers of aging could reveal how insulin-producing cells begin to fail in type 2 diabetes
Rising Blood Sugar: How To Turn It Around
Image: Thinkstock Rising blood sugar signals a need for weight loss and more exercise. Whenever you have routine blood tests at a physical exam, chances are one of the numbers will be a measurement of your glucose, or blood sugar. A normal blood sugar level is less than 100 milligrams per deciliter of blood (mg/dL) after an eight-hour fast. You have diabetes if your blood sugar is 126 mg/dL or higher. But between those two numbers lie many opportunities for action. Subscribe to Harvard Health Online for immediate access to health news and information from Harvard Medical School. Continue reading >>
Healthy Aging With Diabetes
“I can tell you one thing — growing old ain’t for wimps!” —gray-haired gentleman at Sterling Center YMCA in Beverly, Massachusetts It used to be said that having diabetes aged people an additional 20 years. Today, thanks to better tools for managing diabetes and preventing and treating its complications, people with diabetes have the opportunity to live longer than ever before. However, managing diabetes in the golden years presents a variety of challenges, ranging from increased insulin resistance to being on multiple drugs. Here is what you should know about the effects of diabetes on aging and vice versa, and what you can do to stay healthy and full of vitality well into old age. What happens during aging As you age, you may be most aware of your new gray hairs and wrinkles, but aging causes changes throughout the entire body. A person’s basal metabolic rate — the amount of energy the body expends at rest — declines with age. By some estimates, a person’s basal metabolism drops by 2% per decade starting at age 20. Some researchers believe that this decline is due almost solely to the loss of muscle mass that comes with age. The body’s ability to process oxygen — its aerobic capacity — also declines with age. By some estimates, a person’s aerobic capacity by age 65 is typically only 60% to 70% of what it was when he was younger (although the decline appears to be less in older people who exercise regularly). This decline may be due to several factors, including poor lung function, heart function, and blood circulation. With advancing years, the body gradually becomes less adept at taking up and using glucose from the bloodstream — a condition known as glucose intolerance, which sets the stage for Type 2 diabetes. One contributing factor to Continue reading >>
Older Diabetics May Be Pushing Blood Sugar Too Low
(Reuters Health) – Older diabetics may sometimes do too good a job at keeping their blood sugar down, according to a new study. Regardless of age, people with diabetes are taught to keep their blood sugar below certain target levels. But many diabetics over 65 who have other health concerns may be at risk for pushing it too low, according to a new study. Particularly for older adults with multiple serious illnesses and functional limitations, the risks of low blood sugar, or hypoglycemia, may outweigh the benefits of tight blood sugar control, the authors write. “Older people are more susceptible to hypoglycemia,” said lead author Dr. Kasia J. Lipska of the Yale School of Medicine in New Haven, Connecticut. “As people age, their kidney function deteriorates and drugs (like insulin) may not be eliminated from the body as efficiently,” which can lead to low blood sugar, she told Reuters Health by email. Often, people with low blood sugar don’t realize they have it. Symptoms can include double or blurry vision, rapid heartbeat, headache, hunger, shaking or trembling, sweating, tiredness or weakness or feeling faint, trouble sleeping, unclear thinking, and other problems. Severe low blood sugar can cause seizures and brain damage. Intense diabetes treatment, which the study showed many older people are doing, increases the risk for hypoglycemia two to three fold, Lipska said. Her team used data on 1,288 diabetics age 65 or older, from the National Health and Nutrition Examination Surveys from 2001 through 2010. Based on their ability to complete activities of daily life, about half of the participants were generally healthy, 28 percent had “complex or intermediate” health and 21 percent had “poor” health. To see how tightly these patients were controllin Continue reading >>
How Does Diabetes Affect Women Over The Age Of 40?
Diabetes affects how your body processes glucose, which is a type of sugar. Glucose is important for your overall health. It serves as a source of energy for your brain, muscles, and other tissue cells. Without the right amount of glucose, your body has trouble functioning properly. Two types of diabetes are type 1 and type 2 diabetes. Type 1 diabetes Five percent of people with diabetes have type 1 diabetes. If you have type 1 diabetes, your body can’t produce insulin. With proper treatment and lifestyle choices, you can still lead a healthy life. Doctors usually diagnose type 1 diabetes in people who are younger than 40. The majority of people who are diagnosed with type 1 diabetes are children and young adults. Type 2 diabetes Type 2 diabetes is more common than type 1 diabetes. Your risk of developing it increases as you age, especially after age 45. If you have type 2 diabetes, your body is insulin resistant. This means it doesn’t use insulin efficiently. Over time, your body can’t produce enough insulin to maintain consistent blood glucose levels. A number of factors can contribute to type 2 diabetes, including: genetics poor lifestyle habits excess weight high blood pressure Diabetes affects men and women in different ways. Women with diabetes are at higher risk of: heart disease, which is the most common complication of diabetes blindness depression If you’re diagnosed with diabetes, you can take steps to manage your blood sugar and lower your risk of complications. This can include eating a well-balanced diet, exercising regularly, and following your doctor’s prescribed treatment plan. The symptoms typically develop more slowly in type 2 diabetes than type 1 diabetes. Watch out for the following symptoms: fatigue extreme thirst increased urination blu Continue reading >>
Older People And Diabetes
Save for later Most areas of care in diabetes are relevant to all age groups but there are some specific changes due to growing older which might affect your diabetes. Food choices In some cases dietary advice for the older person with diabetes may differ from general recommendations. Older people in care homes are often more likely to be underweight than overweight and there is a high rate of undernutrition. It may not always be appropriate to reduce the fat, salt and sugar for every older person with diabetes. Poor or irregular eating can often be a cause of hypos. Poor oral health, effects of some drugs on the digestive system, limited mobility, dexterity or vision can all cause discomfort associated with eating. Fluid intake is often lower in older people which can cause dehydration, particularly during bouts of illness. People at risk should have a nutritional assessment and individual advice from a dietitian to address areas of concern such as needing extra calories, meal supplements and replacements, weight reduction, low salt diet or manageable foods. Nutritional assessment and diet should form part of your individual care plan if you live in a care home. Personal food preferences are important in any diet plan and older people with diabetes should be able to continue to enjoy a wide variety of foods. Staff, including catering staff in older people's care homes, should have training to give them an understanding of the specific needs of individuals with diabetes. Keeping active Keeping active in later life helps to strengthen muscles, maintain mobility and balance and improves insulin sensitivity. It can help you to continue to self-care, can improve your mental well-being and prevent falls. You can aim to be as active as you are able. Older people, including th Continue reading >>
What Is Normal Blood Sugar In People Over 60?
Age isn’t a factor when it comes to determining a safe blood sugar level. However, the risk of developing type 2 diabetes does increase with age. Diabetes is a condition that occurs when blood sugar levels rise because the body can’t use a type of sugar called glucose normally. If you’re overweight and over age 45, the American Diabetes Association recommends being tested for diabetes during your next routine medical exam. If your weight is normal and you're over 45, ask your doctor if testing is appropriate. Video of the Day Glucose is the body’s main source of energy, and glucose levels in the blood are regulated by the hormone insulin, which is made in the pancreas. Type 1 diabetes occurs if the pancreas doesn’t make any or enough insulin. In the far more common type 2 diabetes, the body doesn’t respond normally to insulin secretions. Both children and adults can suffer from diabetes. Symptoms include extreme thirst, increased urination and unexplained weight loss. To test if you have high blood sugar or might be at risk of developing diabetes, you can take a fasting glucose test, or FGT, or an oral glucose tolerance test, or OGTT. You need to fast overnight before taking either test. With the FGT test, blood glucose is measured first thing in the morning before eating. With the OGTT test, blood glucose is measured after fasting and two hours after drinking a glucose-rich drink. Your fasting blood glucose level is considered normal if it’s below 100 milligrams per deciliter. You’re considered borderline diabetic if your blood sugar is between 100 and 125 mg/dL. If you measure 126 mg/dL or more on two different days, you have diabetes. Without testing, you might not even be aware that your blood sugar is higher than normal, but treatment is important. Continue reading >>
Advanced Glycation End Products (ages) Raise Blood Sugar And Blood Pressure
Advanced glycation end products (AGEs) are formed when sugar reacts with proteins or lipids (fats) in a process called glycation (1). Research shows that some AGE formation occurs when blood glucose levels are over 85 mg/dl. Higher blood glucose levels result in more AGE formation (2). AGEs are also be ingested in the foods we eat. HIGH AGE FOODS INCREASE INFLAMMATION A diet high in AGE compounds has been shown to cause oxidative stress and inflammation in the body (3). In some circumstances, AGEs are involved in a vicious cycle of inflammation, generation of ROS, amplified production of AGEs, more inflammation in a vicious repeating cycle (4). This can result in significant increase in insulin resistance and diabetes (5) Regardless of the increased blood sugar and diabetes risk, chronic Inflammation by itself has been shown to damage every organ in the body, and contribute to aging ( 6). AGEs are formed throughout our lives, gradually adding to our burden of oxidative stress, inflammation, and tissue dysfunction—and ultimately to our cumulative risk of serious chronic age-related diseases. HIGH AGE LEVELS HAVE MANY NEGATIVE HEALTH IMPACTS Excessive levels of AGE compounds has been implicated in many chronic diseases, including heart disease, diabetes, liver disease, Alzheimer’s, arthritis, kidney failure and high blood pressure, among others (7, 8, 9, 10). High glucose levels encourage glycation of structural and functional proteins including plasma proteins and collagen (11). Elevated blood serum AGE levels increase stiffness of arteries and hypertension (12). Protein glycation reactions leading to AGEs are thought to be the major causes of different diabetic complications [13,14], cataracts , atherosclerosis , diabetic nephropathy , and neurodegenerat Continue reading >>
Taste Buds, Blood Sugar And Aging: Is There A Connection To Diabetes?
It is known that 25% of Americans over the age of 65 (11.2 million) are living with diabetes. The study’s leader investigator, Chee Chia, MD stated, “The reduced number of taste buds with advancing age might be linked to the increase incidence of type 2 diabetes among older adults. Dr. Chia is a medical officer at the National Institute of Aging (NIA) in Baltimore, MD. He presented the study's findings during the joint 16th International Congress of Endocrinology and 96th Annual Meeting of The Endocrine Society held in Chicago in June 2014. The results from the National Health Interview Survey, showed less than 1% of people in the 18-24 age group reported taste impairment. In people age 85 and older taste impairment was reported at 1.7%. Furthermore, studies have shown that people with a first-degree relative with type 2 diabetes had impaired sweet taste. According to Dr. Chia’s presentation, people with a first-degree relative and type 2 diabetes needs a glucose solution to be twice as sweet before they can perceive/taste sweet. The investigators analyzed data from 353 adults who participated in the NIA’s Baltimore Longitudinal Study of Aging between 2011 and 2014. This is an observational study of community volunteers. The study (ongoing) counts the number of taste buds on the tip of the tongue after the tongue is stained with blue food dye. “Taste cells are present in the taste buds on the tongue. A taste bud is like an onion-shaped structure consisting of between 15 to 100 taste cells,” Dr. Chia illustrated. Researchers at the NIA found the hormones contained with the taste cells on the tongue in mice to be glucagon and glucagon-like peptide 1 (GLP-1). These are the hormones that help the body regulate sugar. Glucagon increases glucose levels, GLP-1 regu Continue reading >>
Checking blood sugar levels is a way of measuring how well the body uses glucose (GLOO-kose), a sugar that is the chief energy source for cells. After a meal, blood glucose rises. A hormone called insulin helps transport the sugar into cells, where it can be used as fuel. Blood sugar then gradually drops back to normal. Blood sugar levels that remain higher than normal signal two problems: (1) cells are “starving” because they are not absorbing enough glucose and (2) the extra sugar circulating in the blood can damage the eyes, kidneys, nerves, heart and blood vessels. Current guidelines establish two categories of higher-than-normal blood sugar: Prediabetes or “borderline diabetes.” Blood sugar is elevated but not high enough to meet criteria for diabetes. The formal terms for this condition are “impaired fasting glucose” or “impaired glucose tolerance,” depending on how blood sugar is measured. Those with prediabetes are at increased risk of developing cardiovascular disease and diabetes in the future. Diabetes. There are two main types Type 1, in which specialized cells in the pancreas lose their ability to produce insulin. Type 1 diabetes is relatively uncommon and usually occurs in children and young adults. Type 2, in which cells throughout the body lose their ability to respond to insulin About 90 to 95 percent of individuals with diabetes have Type 2. The risk for Type 2 increases with age, although it is diagnosed with growing frequency in all age groups. Other risk factors for Type 2 diabetes include overweight, lack of exercise, high blood pressure, family history of diabetes, and being an African-American, Hispanic American, Native American, Asian American or Pacific Islander. Experts estimate many Americans with Type 2 diabetes have not been Continue reading >>
Type 2 Diabetes In Seniors: Symptoms & Care
My career working with older people began 25 years ago at Community Services for the Blind, where friends, staff, volunteers and clients had lost their sight due to complications from diabetes. Some died at an early age. Today we know much more about the prevention, diagnosis and treatment of type 2 diabetes than we did then. Nevertheless, the disease has reached epidemic proportions in the U.S., afflicting more and more people at younger and younger ages. Type 1 diabetes affects 5% of all people with diabetes and occurs mostly in people under the age of 20. In this condition, the pancreas produces insufficient insulin to maintain normal glucose (blood sugar) levels. The vast majority of people with diabetes have type 2 diabetes, which is characterized by hyperglycemia (excess blood sugar) and insulin resistance. It can cause not only vision loss, but kidney failure, nerve damage, cardiovascular (heart and other artery blockage) disease, as well as increased infections and slowed healing, sometimes resulting in the need for amputation. Type 2 diabetes in seniors is particularly problematic. Type 2 Diabetes Symptoms The most common initial symptoms of type 2 diabetes are increased thirst and frequent urination. Excess glucose in your bloodstream sucks water from tissues, forcing you to want to take in more liquid. Type 2 diabetes is frequently asymptomatic for many years, before initial tell-tale signs of the disease emerge. These include: Flu-like Fatigue Feeling lethargic, tired or chronically weak can be a sign of type 2 diabetes. When your body can't process sugar properly, you'll have chronically low energy. Weight Loss or Weight Gain Because your body is trying to make up for lost fluid and fuel, you may eat more. The opposite can also happen. Even though you eat m Continue reading >>
Hba1c Increases With Age
HbA1c levels in the elderly rise but not in precise relationship to glucose tolerance…. In this cross-sectional analysis of adults with known diabetes, impaired glucose tolerance and HbA1c levels increased with age, even after adjusting for covariates including race, BMI, waist circumference, sagittal abdominal diameter, triglyceride/HDL ratio, and fasting and 2-hour plasma glucose levels assessed by an oral glucose tolerance test. The specificity of HbA1c-based prediabetes diagnosis decreased substantially as age increased. "For the same level of blood glucose, HbA1c is higher in the elderly, suggesting a decreased specificity for the diagnosis of diabetes with increasing age. Given that glucose levels may be normal, basing a diagnosis on HbA1c will result in more risk for hypoglycemia with treatment; on the other hand, one wonders whether the higher HbA1c reflects decreased clearance that may also apply to tissues damaged by glucose, rendering them more susceptible to damage in the presence of ‘normal’ glucose levels," said the researchers. Examining the measures of sensitivity, specificity, and negative and positive predictive value based on HbA1c criteria using the OGTT as gold standard, the researchers found a remarkable decrement in performance, predominantly sensitivity, with age. This is an issue superimposed on the well-recognized problem that the sensitivity of HbA1c for diagnosis of diabetes compared with OGTT is quite limited, clustering in most populations around 50%. Researchers concluded that in two large datasets, using different methods to measure HbA1c, the association of age with higher HbA1c levels was consistent and similar; was both statistically and clinically significant; was unexplained by features of aging; and reduced diagnostic specific Continue reading >>