Diabetes in the elderly

The risk of developing diabetes increases as we get older, usually Type 2 diabetes, which is when the body does not make or use insulin well due to the combined effects of increasing insulin resistance and impaired pancreatic islet function with aging.

Symptoms to watch out for include flu-like fatigue, which includes feeling lethargic and chronically weak, urinary tract infections, numbness and tingling in the hands, arms, legs, and feet due to circulation and nerve damage and dental problems, including infections of the mouth and red, inflamed gums.

People with diabetes can suffer from a hypo, or hypoglycaemia, when the blood glucose level (also called blood sugar) is too low. The most common symptoms of a hypo can include trembling and feeling shaky, sweating, being anxious or irritable, going pale, palpitations and a fast pulse, lips feeling tingly, blurred sight, being hungry, feeling tearful, tiredness, having a headache or lack of concentration.

A hypo should be immediately treated with a fast-acting glucose such as by eating or drinking 15 to 20g of a fast-acting carbohydrate, such as three glucose or dextrose tablets, five jelly babies, a small glass of a sugary (non-diet) drink or a small carton of pure fruit juice and followed up with something starchy like biscuits, a sandwich or the next meal.

Blood glucose can rise quickly during illness, particularly in older people who are dehydrated, so blood glucose monitoring can help to identify older people who may be at risk of hypos.

Having regular mealtimes and snacks containing carbohydrate can help to prevent a hypo.

Caring for someone elderly with diabetes means paying attention to diet, particularly regular meals (little and often), oral health and fluid intake. Particular care is needed when the person is taking medication which can sometimes affect the digestive system.

Helping them to stay active is also important to strengthen muscles, maintain mobility and balance and improves insulin sensitivity.

Older people, including those with frailty, have been shown to benefit from light resistance and balance training. Exercise to build limb strength and flexibility for those who are housebound and confined to a bed or a chair can be taught by a physiotherapist and supported by carers.

Diabetics may also be at greater risk of foot problems, such as redness, pain and build-up of hard skin or changes in foot shape.

Tingling, numbness, throbbing or stinging pain are signs of poor circulation and the causes can include diabetes