Diabetes In Older People
On this page: Diabetes is a serious disease. People get diabetes when their blood glucose level, sometimes called blood sugar, is too high. The good news is that there are things you can do to take control of diabetes and prevent its problems. And, if you are worried about getting diabetes, there are things you can do to lower your risk. What Is Diabetes? Our bodies turn the food we eat into glucose. Insulin helps glucose get into our cells, where it can be used to make energy. If you have diabetes, your body may not make enough insulin, may not use insulin in the right way, or both. That can cause too much glucose in the blood. Your family doctor may refer you to a doctor who specializes in taking care of people with diabetes, called an endocrinologist. Types of Diabetes There are two main kinds of diabetes. Type 1 diabetes. In type 1 diabetes, the body makes little or no insulin. Although adults can develop this type of diabetes, it occurs most often in children and young adults. Type 2 diabetes. In type 2 diabetes, the body makes insulin but doesn’t use it the right way. It is the most common kind of diabetes. It occurs most often in middle-aged and older adults, but it can also affect children. Your chance of getting type 2 diabetes is higher if you are overweight, inactive, or have a family history of diabetes. Diabetes can affect many parts of your body. It’s important to keep diabetes under control. Over time, it can cause serious health problems like heart disease, stroke, kidney disease, blindness, nerve damage, and circulation problems that may lead to amputation. People with type 2 diabetes also have a greater risk for Alzheimer’s disease. What Is Prediabetes? Many people have “prediabetes.” This means their glucose levels are higher than normal but Continue reading >>
Controlling Blood Sugar In Diabetes: How Low Should You Go?
Diabetes is an ancient disease, but the first effective drug therapy was not available until 1922, when insulin revolutionized the management of the disorder. Insulin is administered by injection, but treatment took another great leap forward in 1956, when the first oral diabetic drug was introduced. Since then, dozens of new medications have been developed, but scientists are still learning how best to use them. And new studies are prompting doctors to re-examine a fundamental therapeutic question: what level of blood sugar is best? Normal metabolism To understand diabetes, you should first understand how your body handles glucose, the sugar that fuels your metabolism. After you eat, your digestive tract breaks down carbohydrates into simple sugars that are small enough to be absorbed into your bloodstream. Glucose is far and away the most important of these sugars, and it's an indispensable source of energy for your body's cells. But to provide that energy, it must travel from your blood into your cells. Insulin is the hormone that unlocks the door to your cells. When your blood glucose levels rise after a meal, the beta cells of your pancreas spring into action, pouring insulin into your blood. If you produce enough insulin and your cells respond normally, your blood sugar level drops as glucose enters the cells, where it is burned for energy or stored for future use in your liver as glycogen. Insulin also helps your body turn amino acids into proteins and fatty acids into body fat. The net effect is to allow your body to turn food into energy and to store excess energy to keep your engine running if fuel becomes scarce in the future. A diabetes primer Diabetes is a single name for a group of disorders. All forms of the disease develop when the pancreas is unable to Continue reading >>
What Is Normal Blood Sugar?
Blood sugar, or glucose, is an important source of energy and provides nutrients to your body's organs, muscles and nervous system. The body gets glucose from the food you eat, and the absorption, storage and production of glucose is regulated constantly by complex processes involving the small intestine, liver and pancreas. Normal blood sugar varies from person to person, but a normal range for fasting blood sugar (the amount of glucose in your blood six to eight hours after a meal) is between 70 and 100 milligrams per deciliter. For most individuals, the level of glucose in the blood rises after meals. A normal blood-sugar range after eating is between 135 and 140 milligrams per deciliter. These variations in blood-sugar levels, both before and after meals, are normal and reflect the way that glucose is absorbed and stored in the body. After you eat, your body breaks down the carbohydrates in food into smaller parts, including glucose, which can be absorbed by the small intestine. As the small intestine absorbs glucose, the pancreas releases insulin, which stimulates body tissues and causes them to absorb this glucose and metabolize it (a process known as glycogenesis). This stored glucose (glycogen) is used to maintain healthy blood-sugar levels between meals. When glucose levels drop between meals, the body takes some much-needed sugar out of storage. The process is kicked off by the pancreas, which releases a hormone known as glucagon, which promotes the conversion of stored sugar (glycogen) in the liver back to glucose. The glucose is then released into the bloodstream. When there isn't enough glucose stored up to maintain normal blood-sugar levels, the body will even produce its own glucose from noncarbohydrate sources (such as amino acids and glycerol). This pro Continue reading >>
Type 2 Diabetes Glucose Management Goals
Optimal management of type 2 diabetes requires treatment of the “ABCs” of diabetes: A1C, blood pressure, and cholesterol (ie, dyslipidemia). This web page provides the rationale and targets for glucose management; AACE guidelines for blood pressure and lipid control are summarized in Management of Common Comorbidities of Diabetes. Glucose Targets Glucose goals should be established on an individual basis for each patient, based on consideration of both clinical characteristics and the patient's psycho-socioeconomic circumstances.1-3 Accordingly, AACE recommends individualized glucose targets (Table 1) that take into account the following factors1,2: Life expectancy Duration of diabetes Presence or absence of microvascular and macrovascular complications Comorbid conditions including CVD risk factors Risk for development of or consequences from severe hypoglycemia Patient's social, psychological, and economic status Table 1. AACE-Recommended Glycemic Targets for Nonpregnant Adults1,2 Parameter Treatment Goal Hemoglobin A1C Individualize on the basis of age, comorbidities, and duration of disease ≤6.5 for most Closer to normal for healthy Less stringent for “less healthy” Fasting plasma glucose (FPG) <110 mg/dL 2-hour postprandial glucose (PPG) <140 mg/dL The American Diabetes Association (ADA) also recommends individualizing glycemic targets (Table 2) based on patient-specific characteristics3: Patient attitude and expected treatment efforts Risks potentially associated with hypoglycemia as well as other adverse events Disease duration Life expectancy Important comorbidities Established vascular complications Resources and support system Table 2. ADA-Recommended Glycemic Targets for Nonpregnant Adults3 Parameter Treatment Goal Hemoglobin A1C <6.5% for patients 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 >>
What Is Normal Blood Sugar Level
The blood sugar concentration or blood glucose level is the amount of glucose (sugar) present in the blood of a human or an animal. The body naturally tightly regulates blood glucose levels (with the help of insulin that is secreted by pancreas) as a part of metabolic homeostasis. If blood sugar levels are either increased or decreased by a greater margin than expected this might indicate a medical condition. Diabetic patients must monitor their blood sugar levels as body’s inability to properly utilize and / or produce insulin can pose a serious threat to their health. Navigation: Definition: What is blood sugar? What is diabetes? Diagnosis: Diabetes symptoms Levels and indication Normal blood sugar levels Low blood sugar levels High blood sugar levels Managing: How to lower blood sugar level? Children blood sugar levels Blood sugar levels chart Checking for BS: How to check blood sugar? Treatment: How to lower blood sugar level? Can diabetes be cured? Accessories Diabetic Socks Diabetic Shoes What is blood sugar? What does it mean when someone refers to blood sugar level in your body? Blood sugar level (or blood sugar concentration) is the amount of glucose (a source of energy) present in your blood at any given time. A normal blood glucose level for a healthy person is somewhere between 72 mg/dL (3.8 to 4 mmol/L) and 108 mg/dL (5.8 to 6 mmol/L). It, of course, depends on every individual alone. Blood sugar levels might fluctuate due to other reasons (such as exercise, stress and infection). Typically blood sugar level in humans is around 72 mg/dL (or 4 mmol/L). After a meal the blood sugar level may increase temporarily up to 140 mg/dL (7.8 mmol/L). This is normal. A blood sugar level between 72 mg/dL (4 mmol/L) and 108 mg/dL (6 mmol/L) is considered normal for a h Continue reading >>
Elderly A1c Targets: Should Older People Have More Relaxed Glucose Goals?
You may have read that the lower your A1C level, the better. For best health, people with diabetes should aim for glucose as close to normal as possible. But some new research shows this may not be true for older people. According to these studies, seniors could decide not to shoot for tight control of blood sugar or cholesterol. One study from Japan showed that lower HbA1c levels (a measure of average glucose control over the previous 2–3 months) were actually linked with an increased the risk of frailty in older adults. Frailty was measured in the study as how much help a person needs in living, and how poorly he or she recovers from an illness or injury. Toshihiko Yanase, MD, PhD of Fukuoka University School of Medicine, Japan, reported, “The risk factors of metabolic syndrome, such as high blood glucose, obesity, high cholesterol, and hypertension, in middle age may shift from an unfavorable risk to favorable factors in old age.” The study was published in the Journal of Diabetes Investigation and reported by the online site Healio.com. Yanase and colleagues analyzed data from 132 adults aged at least 65 years with Type 2 diabetes Average age was 78. The subjects had had diabetes for an average of 17 years and their mean A1C was 7.3%. The subjects were categorized as frail or not on a 9-point clinical frailty scale (CFS). The CFS goes from 1 (very fit) to 9 (terminally ill). People who rated 5 or higher were classed as frail. Seventy-seven were not frail; 55 were. In those with higher frailty scores, HbA1c levels were found to be significantly lower. The causes of frailty are not well understood. In men, frailty is strongly associated with loss of muscle mass. As you get weaker and thinner, you become more fragile. The same is probably true of women, although Continue reading >>
What Are Healthy Blood Sugar Levels For Children With Diabetes?
Diabetes mellitus (MEL-ih-tus), often referred to as diabetes, is characterized by high blood glucose (sugar) levels that result from the body’s inability to produce enough insulin and/or effectively utilize the insulin. Diabetes is a serious, life-long condition and the sixth leading cause of death in the United States. Diabetes is a disorder of metabolism (the body's way of digesting food and converting it into energy). There are three forms of diabetes. Type 1 diabetes is an autoimmune disease that accounts for five- to 10-percent of all diagnosed cases of diabetes. Type 2 diabetes may account for 90- to 95-percent of all diagnosed cases. The third type of diabetes occurs in pregnancy and is referred to as gestational diabetes. Left untreated, gestational diabetes can cause health issues for pregnant women and their babies. People with diabetes can take preventive steps to control this disease and decrease the risk of further complications. Continue reading >>
- World's first diabetes app will be able to check glucose levels without drawing a drop of blood and will be able to reveal what a can of coke REALLY does to sugar levels
- Children's Diabetes Foundation The 2017 Carousel Ball - Children's Diabetes Foundation
- Blood Sugar Levels for Adults With Diabetes
Older Women With Unusually High Blood Sugar Levels Run Increased Risk Of Frailty
Latest Research Frailty is a condition associated with aging that boosts risks of poor health, falls, disability and death. Signs of frailty include weakness, weight loss, slow walking speed, exhaustion and low activity levels. Frailty seems to involve problems or "dysfunctions" in many body systems. Research has shown that health problems such as heart disease, obesity, and diabetes can all boost risks of frailty. People with diabetes have dangerously high levels of glucose, a form of sugar, in their blood because their bodies can't use the sugar properly. Unfortunately, growing numbers of older adults are being diagnosed with diabetes, which contributes to many health problems, including frailty. Type 2 diabetes is the most common form of the disease. Unhealthy eating habits, overweight, a sedentary lifestyle, and other "risk factors" can boost the odds of developing type 2 diabetes. If you have pre-diabetes, you have blood sugar levels that are higher than normal, or mild hyperglycemia, but not high enough to be classified as "diabetes." At a higher level of blood sugar, that is, a higher level of hyperglycemia, you have actual diabetes. New Research in the Journal of the American Geriatrics Society To find out whether hyperglycemia, like diabetes and pre-diabetes, is associated with frailty in later life, researchers studied more than 500 women, aged 70 to 79. The women had volunteered to participate in two large studies called the Women's Health and Aging Studies I and II. The women filled out questionnaires about their health, and had medical exams in which healthcare providers, among other things, measured their blood sugar levels and checked for five symptoms of frailty: weight loss, weakness, exhaustion, slowness and low physical activity. Using data from these Continue reading >>
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- World's first diabetes app will be able to check glucose levels without drawing a drop of blood and will be able to reveal what a can of coke REALLY does to sugar levels
- Why do I have high blood sugar levels in the morning?
Hyperglycaemia (high Blood Sugar)
Hyperglycaemia is the medical term for a high blood sugar (glucose) level. It's a common problem for people with diabetes. It can affect people with type 1 diabetes and type 2 diabetes, as well as pregnant women with gestational diabetes. It can occasionally affect people who don't have diabetes, but usually only people who are seriously ill, such as those who have recently had a stroke or heart attack, or have a severe infection. Hyperglycaemia shouldn't be confused with hypoglycaemia, which is when a person's blood sugar level drops too low. This information focuses on hyperglycaemia in people with diabetes. Is hyperglycaemia serious? The aim of diabetes treatment is to keep blood sugar levels as near to normal as possible. But if you have diabetes, no matter how careful you are, you're likely to experience hyperglycaemia at some point. It's important to be able to recognise and treat hyperglycaemia, as it can lead to serious health problems if left untreated. Occasional mild episodes aren't usually a cause for concern and can be treated quite easily or may return to normal on their own. However, hyperglycaemia can be potentially dangerous if blood sugar levels become very high or stay high for long periods. Very high blood sugar levels can cause life-threatening complications, such as: diabetic ketoacidosis (DKA) – a condition caused by the body needing to break down fat as a source of energy, which can lead to a diabetic coma; this tends to affect people with type 1 diabetes hyperosmolar hyperglycaemic state (HHS) – severe dehydration caused by the body trying to get rid of excess sugar; this tends to affect people with type 2 diabetes Regularly having high blood sugar levels for long periods of time (over months or years) can result in permanent damage to parts Continue reading >>
Dementia And Low Blood Sugar: Dangerous Combo For Diabetic Seniors
MONDAY, June 10, 2013 — In older adults with diabetes, low blood sugar and cognitive decline may create a vicious cycle, putting seniors at risk for serious short- and long-term health problems, suggests a study published today in JAMA Internal Medicine. With more than a quarter of U.S. adults over age 65 now living with diabetes, the findings are cause for concern for elderly patients and caregivers alike. People with diabetes are twice as likely to develop Alzheimer's disease or another form of dementia, yet many aren't informed about the link. "Whether you're a diabetes patient or caregiver or doctor, we need to be increasingly aware that there is a very close and interrelated relationship between diabetes and dementia," said Kristine Yaffe, MD, the primary author of the new study and a geriatric neuropsychiatrist at the University of California, San Francisco. Adults with diabetes are at higher risk for vascular disease and stroke, which may make them more susceptible to cognitive disorders. But Dr. Yaffe and her colleagues wanted to explore whether the side effects of some diabetes medications — specifically hypoglycemia, or low blood sugar — might also impact dementia risk. To answer this question, the researchers examined medical records on 783 older adults with diabetes who participated in the federally funded Health, Aging and Body Composition Study. All of the participants were in their seventies and in good cognitive health at the start of the study. During the 12-year follow-up period, adults who were hospitalized for hypoglycemia during the study were twice as likely to be diagnosed with Alzheimer’s disease or another form of dementia. And the troubling relationship appears to run both ways. Those who developed dementia had twice the risk of experie Continue reading >>
Low Blood Sugar Symptoms And Ranges
Low blood sugar (hypoglycemia) definition and facts Hypoglycemia is the medical term for low blood sugar. It typically occurs as a side effect of medications for diabetes. The normal range of blood glucose is from 70 to 100 mg/dL in an individual without diabetes, Most people will feel the effects and symptoms of low blood sugar when blood glucose levels are lower than 50 mg/dL. Low blood sugar is treated by giving a readily absorbed source of sugar, including soft drinks, juice, or foods containing sugar. If the hypoglycemia has progressed to the point at which the patient cannot take anything by mouth, an injection of glucagon may be given. Glucagon is a hormone that causes a fast release of glucose from the liver. Hypoglycemia or low blood sugar is syndrome that results from low blood sugar. The severity and symptoms of hypoglycemia can vary from person to person. Blood tests can diagnose low blood sugar, and symptoms resolve when the levels of sugar in the blood return to the normal range. The medical term for blood sugar is blood glucose. What can cause low blood sugar? Despite advances in the treatment of diabetes, low blood sugar episodes occur as a side effect of many treatments for diabetes. In fact, these episodes are often the limiting factor in achieving optimal blood sugar control, because many medications that are effective in treating diabetes carry the risk of lowering the blood sugar level too much, causing symptoms. In large scale studies looking at tight control in both type 1 and type 2 diabetes, low blood sugars occurred more often in the patients who were managed most intensively. This is important for patients and physicians to recognize, especially as the goal for treating patients with diabetes becomes tighter control of blood sugar. While peopl Continue reading >>
Diabetes In The Elderly
Key Messages Diabetes in the elderly is metabolically distinct from diabetes in younger people and the approach to therapy should be different. Sulphonylureas should be used with caution because the risk of hypoglycemia increases exponentially with age. Long-acting basal analogues are associated with a lower frequency of hypoglycemia than conventional insulins in this age group. In elderly people, if mixture of insulin is required, the use of premixed insulins as an alternative to mixing insulins minimizes dose errors. Highlights of Revisions A new recommendation for glycemic targets among the frail elderly of glycated hemoglobin (A1C) ≤8.5%, and fasting and preprandial plasma glucose of 5.0 to 12.0 mmol/L has been added. The chapter recognizes the importance of hypoglycemia avoidance over achieving glycemic targets among the frail elderly and those with cognitive impairment. A new recommendation about the use of regular diets in nursing homes instead of "diabetic diets" has been added. Recommendations Healthy elderly people with diabetes should be treated to achieve the same glycemic, blood pressure and lipid targets as younger people with diabetes [Grade D, Consensus]. In the frail elderly, while avoiding symptomatic hyperglycemia, glycemic targets should be A1C ≤8.5% and fasting plasma glucose or preprandial PG 5.0–12.0 mmol/L, depending on the level of frailty. Prevention of hypoglycemia should take priority over attainment of glycemic targets because the risks of hypoglycemia are magnified in this patient population [Grade D, Consensus]. In elderly people with cognitive impairment, strategies should be used to strictly prevent hypoglycemia, which include the choice of antihyperglycemic therapy and less stringent A1C target [Grade D, Consensus]. Elderly people Continue reading >>
Diabetes In Older Adults
What is the epidemiology and pathogenesis of diabetes in older adults? According to the most recent surveillance data, the prevalence of diabetes among U.S. adults aged ≥65 years varies from 22 to 33%, Continue reading >>
* What Is A Normal Blood Sugar?
Normal blood sugars after a high carbohydrate breakfast eaten at 7:30 AM. The blue line is the average for the group. The brown lines show the range within which most readings fell (2 standard deviations). Bottom lines show Insulin and C-peptide levels at the same time. Click HERE if you don't see the graph. Graph is a screen shot from Dr. Christiansen's presentation cited below. The term "blood sugar" refers to the concentration of glucose, a simple, sugar, that is found in a set volume of blood. In the U.S. it is measured in milligrams per deciliter, abbreviated as mg/dl. In most of the rest of the world it is measured in millimoles per liter, abbreviated as mmol/L. The concentration of glucose in our blood changes continually throughout the day. It can even vary significantly from minute to minute. When you eat, it can rise dramatically. When you exercise it will often drop. The blood sugar measures that doctors are most interested in is the A1c, discussed below. When you are given a routine blood test doctors usually order a fasting glucose test. The most informative blood sugar reading is the post-meal blood sugar measured one and two hours after eating. Doctors rarely test this important blood sugar measurement as it is time consuming and hence expensive. Rarely doctors will order a Oral Glucose Tolerance Test, which tests your response to a huge dose of pure glucose, which hits your blood stream within minutes and produces results quite different from the blood sugars you will experience after each meal. Below you will find the normal readings for these various tests. Normal Fasting Blood Sugar Fasting blood sugar is usually measured first thing in the morning before you have eaten any food. A truly normal fasting blood sugar (which is also the blood sugar a norm Continue reading >>