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Aging Well With Diabetes

by Laura Hieronymus, MSEd, RN, BC-ADM, CDE, Bob Moss, PharmD, and Parminder Kaur, PharmD, MBA

Healthy eating
Making healthy food choices and becoming familiar with how various foods — and amounts of food — affect your blood glucose level are essential for optimal blood glucose control. Your diabetes education should cover how to estimate food portion sizes, how to read Nutrition Facts labels, and how to time your meals in relation to physical activity and taking your diabetes medicines. (Some medicines, for example, must be taken within a certain time frame, such as before or after you eat.) Your physician or dietitian may also have individualized nutrition recommendations for you, such as eating more calcium-rich foods or taking vitamin D supplements, based on your age or other medical conditions you may have.

As you get older, it is particularly important to notice any significant changes in your weight. Gaining or losing weight can affect your blood glucose control and require changes in your diabetes management regimen. Gaining or losing weight unintentionally may also be a sign of other medical problems that should be attended to. If you’re experiencing any issues that affect your eating habits — including problems with chewing or swallowing, diminished ability to taste food, feeling full soon after starting meals, or eating more or less than usual because of a depressed mood — take the time to discuss those issues with your physician and/or diabetes educator.

If you’re on a budget and need to limit the amount of money you spend on food, discuss this with your dietitian or diabetes educator. These professionals may be able to help you identify inexpensive foods that are high in nutrients or to locate resources that can assist you in eating healthfully at a lower cost. For example, many senior centers offer low-cost meals, and there are programs — such as Meals on Wheels — that prepare and deliver meals to seniors with limited physical mobility.

Being active
Not only is physical activity beneficial to blood glucose and weight control, but it also helps you to feel better and stronger physically and emotionally. When aerobic physical activity such as walking or swimming is performed on a regular basis, it can improve your cardiovascular health by helping to lower high blood pressure and high triglycerides and to raise your HDL, or “good,” cholesterol.

Regular strength training (also called “resistance” training) also has numerous benefits, particularly as you grow older. Like aerobic exercise, strength training can improve your heart health and help with blood glucose control. Other benefits include being stronger, having more muscle mass and less body fat, feeling less depressed, and feeling more self-confident.

Exercise is also important for bone health, and women especially need to be attentive to bone health as they age. Women with Type 1 diabetes are at an increased risk for osteoporosis, a condition in which bones lose their density and strength over time, raising the risk of fractures. Women with Type 2 diabetes and a sedentary lifestyle are also at increased risk of fractures. In either case, regular weight-bearing activities, such as walking, jogging, playing tennis, and dancing, are beneficial to protecting bones. Strength and balance exercises, such as tai chi, may also help you avoid falls, reducing your chance of breaking a bone.

When you have diabetes, it’s a good idea to talk to your health-care team about the types and amounts of physical activity that are safe and appropriate for you. If you have physical limitations that prevent you from engaging in basic activities such as walking or bicycling, ask your health-care team for advice on how to be more active within your limitations.

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