Challenges to Diabetes Care As you grow older
By Nancy M. Ouhib, MBA, RDN, LDN / February 1, 2015

Approximately one out of four Americans over the age of sixty has diabetes mellitus. Managing the disease can become more difficult as people start into the golden years.

Two of the most important things aging people can do are admit they need help and ask for it. This applies to all medical conditions that may be pertinent. In regards to diabetes, a lot of people do not want to admit that they are not checking their glucose levels. If you find that you cannot comply with your self-regimen, it is important to talk to your health care provider. Being honest will allow you to work together to come up with a system that is realistic for you. It is also important to let your provider know about any changes that your body is going through even if they seem minor to you. For example, you need to tell your physician if you are feeling weak, tired, or light-headed. Pay attention to your body, and when something does not feel right, you need to tell someone. The smallest change may be important to note for a person with diabetes.

Challenges to Diabetes Care As you grow older
Here are some of the more common challenges for aging people with diabetes mellitus that you will want to discuss with your provider:

Vision Care: More than 28 percent of people over the age of 40 living with diabetes experience diabetic retinopathy. Diabetic retinopathy is damage to the small blood vessels in the retina than can result in loss of vision. As people age their vision deteriorates, especially if blood glucose levels are uncontrolled. Cataracts can also contribute to poor vision. Poor vision makes it more difficult to read the directions on medications, to see blood glucose levels on a meter, or even to walk down stairs without falling. Have your vision checked regularly.

Hearing Care: People with diabetes are twice as likely to experience hearing loss as those without diabetes, suggesting that it may be a complication of the disease. Hearing loss is a gradual process that occurs with age. All seniors should have their hearing checked on a regular basis, and those with diabetes should be diligent about this.

Technology: Technological advances are intended to make life simpler. These advances can actually make things more difficult for people who do not adapt well to changes in their medical devices or routines. There are devices out now that track and record glucose levels over time. For a senior that does not understand how to operate the device, they may not know what the number registering on the device is for - whether it is today or seven days ago. It is best to get equipment that is as simple as possible. Make sure you ask your provider to explain to you how to use the device and practice in front of him/her until you are comfortable with it.

Medication: Seniors should keep a card in their wallet of what medications they are taking, how much and when. The same information should be available in the home in a visible location. Medications should be timed around meals or when a caregiver is available so that medications are taken as directed. Every effort should be made to accommodate the person's restrictions and capabilities, so compliance can be achieved.

Fine Motor Skills: The elderly struggle with fine motor skills, and these can be worsened by arthritis and vision problems. Daily diabetes self-care, such as picking up a test strip, loading a syringe or giving an injection, can be difficult and stressful. Family members need to be aware of this and make sure a caregiver is available to assist with these tasks.

Stay Active: Aging joints, shortness of breath, slower movement, and fear of falling can discourage seniors from being active when, in fact, in most cases they need to remain active. Being sedentary only worsens the above challenges. People should always check with their provider regarding their exercise and activity level based on their medical conditions.

Altering your diabetes care routine can help you to focus on safety, health, and less stress. This allows you to improve your daily function and quality of life.

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