Type 2 diabetes has become increasingly problematic, particularly in the elderly. What we do when we are young ”“ eating badly, drinking to excess, remaining sedentary ”“ affects us as we age. (In our end is our beginning.) Bad habits can lead to diabetes, which is in turn exacerbated by the continuing pandemic ”“ like so many other things. People with diabetes are more likely to have severe Covid symptoms, and those with Covid are faced with an increased risk of a diabetes diagnosis.
There are two main types of diabetes ”“ Type 1, commonly known as juvenile diabetes, which is a disease that usually occurs during childhood, even at birth, and is diagnosed when the pancreas provides little or no insulin. Type 2 diabetes is also referred to as Type 2 mellitus as well as adult-onset diabetes. It is the most common form of diabetes and occurs when the body does not use insulin properly or does not make enough of it. Diabetes can lead to eye, heart and kidney disease, poor circulation, amputation, cognitive decline, depression and death.
Currently there are 366 million people with diabetes mellitus worldwide, with more than 23 million people living in the United States with it. This number is projected to reach 552 million by 2030. The statistics for the elderly are quite staggering: One third of the elderly population has diabetes and three quarters of the elderly population has prediabetes ”“ in which glucose levels are not high enough to be classified as diabetes ”“ or diabetes itself. A large portion of older adults with Type 2 diabetes, 45.6%, are undiagnosed. Chances are many prediabetics will eventually be diagnosed as diabetics. With a high incidence of disease and an aging population, forecasts project the number of cases of diagnosed diabetes among people aged 65 years and older will grow more than fourfold by 2050.
Diabetes management in the elderly should focus on mitigation and prevention, including of hypoglycemia (low blood glucose, or sugar), and neurocognitive dysfunction. According to the Mayo Clinic, hypoglycemia ”“ characterized by dizziness, heart palpitations, confusion, shakiness and sudden extreme fatigue ”“ occurs when blood sugar is below 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L). It may require eating something sweet or starchy, like a sandwich, to redress it. Medication is also used.
In any event, avoiding it would be a priority in any type of intervention for Type 2 diabetes, as would avoiding hyperglycemia, or high blood sugar (blood glucose of more than 240 mg/dL or 13.3 mmol/L), which is characterized by frequent urination, increased thirst, blurred vision and fatigue. It can lead to eye, kidney, nerve and heart disease as well as diabetic coma.
Lifestyle modification, specifically in the form of physical activity and good nutrition are the keys to glycemic and metabolic control. When it comes to nutrition, avoiding highly sugary foods, deserts and sweet fruits and drinks, while consuming protein as well as high fiber (20 to 40 grams a day) should be optimal for all but especially the elderly. Regular exercise ”“ including aerobic and weight-bearing activities and/or resistance training ”“ should be encouraged in all, including older adults who can safely engage in movement.
“In my end is my beginning”: There”™s another way to look at this quote. Out with the old and in with a fresh start. It was another Mary, the 19th-century novelist Mary Ann Evans, better known as George Eliot, who said, “It”™s never too late to be what you might”™ve been.” Avoiding diabetes can ultimately lower medical costs, hospitalizations and the need for medications while preventing disease and offering myriad other health benefits to our society that improve quality of life.
Reach Giovanni at giovanniroselli.com.
