By Glenn Ellis
More and more, I am finding many people who as they enter their sixth decade find new aches and pains that never existed before. Increasingly, many find something else that never existed before: diabetes. For most of these people, after a lifetime of enjoying reasonably healthy lives, seemingly out of nowhere, they are told they are now diabetic, and prescribed medication. Needless, to say, this comes as a shock!
However, consistent with many other changes in the body as we age, your body becomes more susceptible to diabetes.
Of course, seniors (those over 65) are not the only people to be affected by diabetes. According to the Centers for Disease Control and Prevention (CDC), over 30 million people in the United States have diabetes. The CDC also notes that 90 to 95 percent of cases involve type 2 diabetes. More than one-quarter of the U.S. population aged 65 and older has diabetes and approximately one-half of older adults have pre-diabetes. In this population, age-related insulin resistance and impaired pancreatic islet function increase the risk of developing the disease.
Many older people also have other conditions as well as diabetes, and this can complicate diabetes management. For example, high blood pressure or high levels of certain fats in the blood can speed up the progression of common complications of diabetes, such as kidney problems, eye problems, foot problems and heart and blood vessel problems. People with diabetes whose blood glucose levels are high are more prone to infections than people with normal blood glucose levels.
People with poorly controlled diabetes are also at greater risk for dental problems. They’re more likely to have infections of their gums and the bones that hold their teeth in place, because diabetes can reduce the blood supply to the gums.
Not only that, but when we age, loss of teeth and poor dental health becomes more and more common. As a result, what we eat, and how we eat (along with age-related poorer appetite). We don’t, and can’t, chew like we used to. That means things like crunchy fruits and vegetables are off-limits. We end up gravitating towards softer chewy foods that tend to be more processed, and bad for our health in the long run.
A poor diet of soft and processed foods can have serious long-term effects, especially on the seniors or those with systemic health issues like heart disease and diabetes. Specifically, a poor diet can lead to either unhealthy weight loss or unhealthy weight gain, high blood pressure, high cholesterol, malnutrition, dehydration, jawbone loss, osteoporosis, stroke, and some cancers. Poor nutrition can also cause even more oral health issues, including gingivitis and tooth decay.
If we look, honestly, at all the things that go along with aging, we find that it makes sense that the risk of becoming diabetic increases as we get older. In addition to their many physical challenges, elderly diabetes patients often are socially isolated and have financial problems that negatively affect their care. They may forget to eat, be unable to afford medications or quality food, or skip medication doses to extend a prescription. They also may experience changes in taste and a lack of interest and ability to shop for food and prepare meals at home.
An additional concern with blood sugar being too high, is the danger of blood sugar dropping too low (hypoglycemia). This creates the conditions for many serious issues that wreak havoc in the lives of the elderly; particularly falls and fractures. Instead of, or in addition to, sweating and tremors, elderly diabetes patients should be taught to look for symptoms of hypoglycemia, such as dizziness, weakness, delirium, and confusion. Often, the low glucose will cause them to fall, resulting in a head injury and death.
There is good news! Despite the high rates of diagnosis, there are ways the disease may be delayed and even prevented. Your best options include regular exercise; losing 5 to 10 percent of your body weight if you’re overweight or obese; and reducing your intake of sugar and sweetened beverages. If we are all honest with ourselves, one or more of these risk factors is a part of who we are, and how we have grown accustomed to living. By losing just 5 to 7 percent of your body weight, you can slow the development of type 2 diabetes.
You may not be able to prevent diabetes entirely. But taking steps now may prevent related complications and improve your quality of life.
Glenn Ellis, is Research Bioethics Fellow at Harvard Medical School and author of Which Doctor?, and Information is the Best Medicine. Ellis is an active media contributor on Health Equity and Medical Ethics. For more good health information visit: www.glennellis.com.