Aging with diabetes is not a curse. It can be a positive time of growth, happiness, and peace. However, it’s important to note that managing diabetes in the golden years may present challenges ranging from changes in metabolism and increased insulin resistance to medication management. But thanks to better tools and technology advancements, people managing diabetes have the opportunity to live longer than ever before.
Here is a list of 12 strategies to help you manage your diabetes with confidence as you age.
1. Control your glucose levels.
If you can keep your glucose close to normal, you dramatically reduce the risk of diabetes-related complications.
How tight should control be? Some say lower is better, but lower also means more risk of hypoglycemia (low blood sugar), which can cause dizziness, falls, and other accidents. Because of risks like these, the American Diabetes Association (ADA) recommends looser diabetes control for older people. Whereas younger adults are usually advised to keep the hemoglobin A1C (a measure of average glucose levels for the previous two to three months) under 7 percent, people over 65 may be advised to shoot for 7.5 percent. Seniors in poor health may be told that 8 percent or even higher is the best target for them, despite the risfak that complications may increase with higher A1C numbers.
Some experts believe that how you keep sugars down is more important than the actual numbers. Many times, doctors will pile on medications to lower sugars or treat the health problems of aging with diabetes. Overprescribing creates a number of problems. Because older people have less kidney and liver function to process drugs, they have more risk of interactions and side effects.
However, controlling your A1C with exercise and healthy, low-carb, high-fiber eating does not carry the risks of control by drugs. You may want to work with your health-care practitioner to find a plan that’s right for you and talk with your pharmacist and doctor about lowering doses or discontinuing some drugs. The same applies to herbal medications — if you’re older, start with lower doses.
2. Stay physically active.
The more you move, the better your circulation will be, and the better your cells will soak up glucose. you will have more energy and more self-confidence. Walk or exercise after meals, drive less, and use the stairs.
The ADA recommends the following ways to stay physically active:
• Strengthening exercise builds stronger muscles, which use more glucose.
• Balance exercises such as standing on one foot (with or without arm support) help prevent falls.
• Aerobic exercises such as walking, running, or swimming help increase cardiovascular fitness.Check with your doctor before starting.
• Stretching, yoga, or tai chi help increase flexibility.
3. Prepare for aging.
If you can, get into a living situation that is accessible and affordable. Modify your home or look into senior housing or assisted living before you need it. Consider moving in with family or having them move in with you. Arranging for suitable housing as you age will ensure your comfort and safety for years to come.
4. Do the things that make you happy.
If you enjoy music, gardening, reading, or knitting, make time in your schedule to do what brings you joy. Another rewarding option is giving your time, whether to your family, friends, or the charitable organization of your choice. The benefits of volunteerism are long lasting.
5. Stay connected.
Keep family and friends in your life close. Schedule time with those you care about most. Conversation, friendship, and companionship are key to staying emotionally fit.
This also applies to pets. Some people gain a wonderful sense of connection from pets. Dogs especially can solve a lot of diabetes issues — they promote exercise, love, and joy and require a regular schedule. Dogs also help you meet new people when you take them for a walk.
6. Keep up with your health care.
As we age, it may become harder to get to medical appointments or to pay for them. Managing preventable and treatable conditions is important. Here is a list of important appointments to schedule:
• ophthalmologist (eye doctor) once a year to check for diabetic eye disease (retinopathy) and make sure you have the proper eyeglass prescription;
• endocrinologist (diabetes doctor or general practitioner/nurse practitioner) twice a year or more; and
• podiatrist (foot doctor) once a year, or more if prescribed.
It is important to shoot for eight hours of sleep a night. To ensure a restful night’s sleep, try not to watch TV or do things that wind you up right before bedtime. Avoid stimulants — coffee, tea, and other caffeinated beverages — in the evening, and take time to wind down before stretching out.
If you find yourself waking in the night or early morning, discuss this with your doctor. If you have trouble staying asleep or wake up exhausted, be evaluated for sleep apnea — a common condition in people with diabetes.
> Exercise Recommendations for Older Adults
Diabetes in Control
> What We Recommend
American Diabetes Association
MAINTAINING MENTAL HEALTH
> Free depression self-test
KEEPING YOUR BRAIN STRONG
GETTING YOUR ZZZs
> Healthy Sleep Tips
National Sleep Foundation
> Sleep Apnea Self-Test
American Sleep Apnea Foundation
MAKING SOCIAL CONNECTIONS
> 36 Ways to Make New Friends After 60
Savoring Your Sixties
> Low-income rental housing
8. Watch out for depression.
According to the ADA, people with diabetes are at a higher risk for depression. If you are feeling sad, no longer want to do things you used to like, wake early for no reason, experience changes in appetite, or feel tired, anxious, or hopeless, get help. Poorly controlled diabetes can cause those symptoms, but they could also be signs of depression. Self-management, counseling, and/or medications, along with sunshine, exercise, and social contact are ways to combat depression.
9. Practice spirituality.
Prayer and meditation improve health and quality of life. People who belong to a congregation tend to live longer and be happier than people who are not religious, in part because of the social support religions offer.
10. Stay mentally active.
Puzzles or online brain training programs like Lumosity are great tools to keep the mind moving. Other fun activities include:
• learning a new language or finding a new hobby;
• joining a discussion group or a book club;
• preparing new recipes; and
• taking a class at a local school or senior center or online.
11. Reach out for assistance.
Aging and illness both increase the need for help. Help could include diabetes equipment, like a glucose monitor or insulin pump, or mobility equipment like a cane, walker, or grab bars. It could include financial assistance like disability or social security payments. Apply for the benefits you may be entitled to such as Medicare, Social Security, or disability as soon as you can. They often take time to come through.
The most important help often comes from other people. Your family, friends, neighbors, or volunteers may be happy to help with shopping, housework, traveling, to appointments and more.
In many cases, a spouse is the person we lean on the most. Be aware: over-reliance can cause burnout. The goal is to keep all in your household healthy.
12. Be safe.
It’s not always the complications of chronic illness that knock you down. It is the one-time injuries we call “accidents.” They’re not really accidents; they’re dangerous situations we haven’t dealt with. To avoid health risks associated with diabetes, including falls, auto accidents, and severe hypoglycemia, it’s important to prevent them. Here are some tips.
• Get all the clutter off your floors.
• Install good lighting and grab bars if you need them.
• Wear good-fitting shoes.
• Don’t drive when your sugar is borderline or when you don’t feel well or at night if you have visual problems. Get a ride, take the bus, or walk.
Want to learn more about how to age well with diabetes? Read “Healthy Habits for Aging: Four Steps You Can Take,” “Healthy Habits for Aging: More Steps You Can Take,” “Aging Well With Diabetes,” and “Healthy Aging With Diabetes.”