3. Practice preventive medicine
A good way to stay healthy is to detect and treat medical problems early — or, better yet, to prevent them altogether. Preventive measures you can take include getting screened for diabetes complications, cancer and other conditions; getting immunizations; and taking precautions to prevent falls and injuries.
An important concern for women with diabetes is screening for and preventing cardiovascular disease. Having high blood cholesterol and/or high blood pressure raises your risk of heart disease, so you should have your cholesterol checked once a year (or as recommended by your doctor) and your blood pressure checked every time you visit your doctor. You should also get tested once a year for microalbuminuria, or protein in the urine, an early sign of nephropathy and a risk factor for heart attack and stroke. In addition, you should have your HbA1c level checked two to four times each year to get an idea of how well you’re controlling your blood glucose level. Keeping your blood glucose as close to normal as possible helps you reduce your risk for diabetes complications.
According to the National Cancer Institute (NCI), 1 in 8 women will develop breast cancer at some point in her life, and 1 in 18 will develop colorectal cancer. Detecting these types of cancers early makes treating them more likely to be successful. The U.S. Preventive Services Task Force recommends that women age 50 and over get a mammogram (a screening test for breast cancer) every one to two years. Several tests can detect cancer of the colon or rectum, and the American Cancer Society recommends that starting at age 50, all people at average risk of the condition have either a fecal immunochemical blood test once a year and flexible sigmoidoscopy every five years, a colonoscopy once every 10 years, or a CT colongraphy every five years. In addition, getting regular pelvic exams and Pap smears can help detect cervical, vaginal and other gynecological cancers.
Another wise precaution to take is getting immunized against pneumonia and influenza. Cases of pneumonia and the flu can be more serious and cause more complications in older people — in fact, pneumonia and influenza are the fifth leading cause of death for people 65 and older. Having diabetes also raises your risk of flu complications, including pneumonia. The Centers for Disease Control and Prevention (CDC) recommends that people over 65 get a flu shot every September or October; it can greatly reduce your chances of contracting the flu. It is possible to get the flu even after getting a flu shot, but your case will be milder than if you had not been immunized. The CDC also recommends the pneumonia vaccine for all people 65 and older. People in this age group should have two doses of the vaccine, at least one year apart. If you haven’t had a pneumonia or flu shot, talk to your doctor about getting them.
Medicare helps pay for many different preventive measures and screening tests. If you have Medicare Part B, you can get one flu shot each year and two pneumonia shots of a different type in your lifetime. You may also receive one pelvic exam, clinical breast exam and Pap smear every two years (or every year if you’re at high risk for gynecological cancer). One mammogram is covered every year, as is one fecal occult blood test. Other colorectal cancer screening tests are also covered; you can get a flexible sigmoidoscopy or barium enema once every four years or a colonoscopy once every 10 years (unless you have had a sigmoidoscopy in the last four years). If you’re at high risk for colon cancer, you can get a colonoscopy every two years. If you don’t have Medicare, contact your insurance provider to find out what your plan covers.
Another concern for older women, particularly for those who have osteoporosis or are at high risk of developing it, is preventing falls and bone fractures. Hip fractures in particular can be quite serious: According to the American Association of Orthopedic Surgeons, nearly one in four older people die within a year of fracturing a hip, and about 40% are unable to live independently after their hip fracture. Most serious falls occur in the home, so take steps to make your house fall-proof, such as tacking down rugs, cleaning up clutter and putting nonslip mats in your shower and by your bathroom and kitchen sinks. Doing aerobic, weight-bearing and stretching exercises can also help prevent falls because they strengthen your muscles, increase your range of motion and improve your balance.
4. Take care of your feet
Having diabetes raises your risk of getting foot infections, so it’s important to pay attention to foot care. A common complication of diabetes is neuropathy, which can lead to a loss of sensation in the feet. If you can’t feel a cut, scrape or blister on your foot, you may not treat it, and it may develop into an ulcer. An untreated ulcer can become infected, and, if the infection is serious enough, amputation can be necessary.
To help prevent foot ulcers and infections, follow these foot-care steps:
- Check your feet once a day for cuts, sores, blisters, or calluses.
- Wash your feet with warm water and mild soap every day.
- Moisturize the tops and bottoms of your feet every day.
- Choose comfortable shoes that don’t pinch or place a lot of pressure on any single part of your foot (for example, avoid high heels).
- Have your primary-care physician or podiatrist examine your feet at least once a year.
To really stay on top of the condition of your feet, check them at home for loss of sensation. The Lower Extremity Amputation Prevention Program (LEAP) offers a free screening kit to do just that. The kit includes a device called a monofilament that you or someone else touches to the bottom of your foot in several places. If you don’t feel the touch, tell your doctor.