Seniors and Diabetes

The following article was originally published by National Care Planning Council:

In 2011, almost 11 million older adults living in the U.S–nearly 27 percent of people 65 or older–have diabetes. [i] Below is some information and tips on how to manage and prevent Diabetes.

I don’t have Diabetes, what is it?

Diabetes means your blood glucose (often called blood sugar) is too high. Your blood always has some glucose in it because your body needs glucose for energy to keep you going. But too much glucose in the blood isn’t good for your health. [i]

Glucose comes from the food you eat and is also made in your liver and muscles. Your blood carries the glucose to all of the cells in your body. Insulin is a chemical (a hormone) made by the pancreas. The pancreas releases insulin into the blood. Insulin helps the glucose from food get into your cells. [i]

If your body does not make enough insulin or if the insulin doesn’t work the way it should, glucose can’t get into your cells. It stays in your blood instead. Your blood glucose level then gets too high, causing pre-diabetes or diabetes. [i]

Aren’t there different types of Diabetes?

So glad you asked. There are three main kinds of diabetes: type 1, type 2, and gestational diabetes. The result of type 1 and type 2 diabetes is the same: glucose builds up in the blood, while the cells are starved of energy. [i]

Type 1 Diabetes

Type 1 diabetes, formerly called juvenile diabetes or insulin-dependent diabetes, is usually first diagnosed in children, teenagers, or young adults. With this form of diabetes, the beta cells of the pancreas no longer make insulin because the body’s immune system has attacked and destroyed them. About 5 to 10 percent of people with diabetes have type 1 diabetes. [i]

Type 2 Diabetes

Type 2 diabetes, formerly called adult-onset diabetes or non-insulin-dependent diabetes, is the most common form of diabetes. People can develop type 2 diabetes at any age — even during childhood. This form of diabetes usually begins with insulin resistance, a condition in which the body not use insulin properly. At first, the pancreas keeps up with the added demand by producing more insulin. In time, however, it loses the ability to secrete enough insulin in response to meals. 95% of people with diabetes have type 2. Type 2 diabetes is also more common in people with a family history of diabetes and in African Americans, Hispanic Americans, American Indians, Alaska Natives, and Asian and Pacific Islanders. Being over 45 years of age and overweight or obese raises the risk of developing type 2 diabetes. [i]

Gestational Diabetes

Some women develop gestational diabetes during the late stages of pregnancy. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Although this form of diabetes usually goes away after the baby is born, a woman who has had it and her child are more likely to develop diabetes later in life. In fact, women who have had gestational diabetes have a 35% to 60% chance of developing diabetes in the next 10-20 years, according to the CDC. [i]

Pre-diabetes

Pre-diabetes means your blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. People with pre-diabetes are at an increased risk for developing type 2 diabetes and for heart disease and stroke. The good news is that if you have pre-diabetes, you can reduce your risk of getting type 2 diabetes. With modest weight loss and moderate physical activity, you can delay or prevent type 2 diabetes. [i]

What are some signs of Diabetes?

Many people with diabetes experience one or more telling symptoms, including extreme thirst or hunger, a frequent need to urinate and/or fatigue. Some lose weight without trying. Additional signs include sores that heal slowly, dry, itchy skin, loss of feeling or tingling in the feet and blurry eyesight. Some people with diabetes, however, have no symptoms at all. [i]

If Diabetes is Not Controlled

Diabetes is a very serious disease. Over time, diabetes that is not well controlled causes serious damage to the eyes, kidneys, nerves, and heart, gums and teeth. If you have diabetes, you are more than twice as likely as people without someone who does not have diabetes to have a heart disease or a stroke. People with diabetes also tend to develop heart disease or stroke at an earlier age than others. Over the years, high blood glucose damages nerves and blood vessels, oftentimes leading to complications such as heart disease, stroke, blindness, kidney disease, nerve problems, gum infections, and amputation. [i]

Economic Burden of Diabetes in the US

$174 billion – Total costs of diagnosed diabetes in the United States in 2007.[iii]

• $116 billion for direct medical costs [iii]
• $58 billion for indirect costs (disability, work loss, premature mortality) [iii]

After adjusting for population age and sex differences, average medical expenditures among people with diagnosed diabetes were 2.3 times higher than what expenditures would be in the absence of diabetes.[iii]

The total cost of diabetes in the United States in 2007 was $218 billion.[iii]

• $174 billion for people with diagnosed diabetes [iii]
• $18 billion for people with undiagnosed diabetes [iii]
• $25 billion for American adults with pre-diabetes [iii]
• $623 million for gestational diabetes [iii]

Preventing Diabetes

Whether you’re 20 or your 65 and you have yet to become Diabetic, it’s very important to do a few simple things to help in the prevention of Diabetes.  There are a few major things you can do to aid in the prevention of Diabetes:

• Control Stress
• Eat a balanced diet
• Exercise
• Limit sugar intake
• Regular Dr. Checkups
• Quit smoking (if applicable)

Controlling Diabetes

If you are already diabetic, it is very important to manage your diabetes.

Check blood glucose levels each day and log the results. This way you and your doctor can determine if your diabetes management plan is working. [ii]

Eat a balanced diet

Manage Stress

• Relaxation techniques, practiced regularly, have been found to help people with type 2 diabetes — for whom stress blocks the body from releasing insulin — better manage their bodies’ ability to regulate glucose and thereby avoid complications. [iv]

Exercise

• It has been shown to improve glucose tolerance – meaning that blood sugars are controlled with less medication. [iv]
• It lowers the chance of developing serious complications from diabetes. [iv]
• It helps the body manage stress. [iv]
• It helps with weight control. [iv]

Visit your Dr regularly

Quit smoking (if applicable)

• Unfortunately, smoking increases a person’s chance of developing diabetes complications — such as retinopathy, heart disease, stroke, vascular disease, kidney disease, nerve damage, problems with feet and more — in addition to increasing their risk of developing diabetes in the first place.  [iv]

Food to Eat and Avoid

Breads and Grains

Vegetables

Fruit

Meats and Protein

Dairy

Fats, Oils, Sweets

Beverages

Tables above are from: WebMD

10 Dangerous Foods to Avoid

Candy

Not only do high-sugar foods like candy, cookies, syrup, and soda lack nutritional value, but these low-quality carbohydrates also cause a dramatic spike in blood sugar levels and can contribute to weight gain, both of which can worsen diabetes complications. Learn to satisfy your sweet tooth by snacking on high-quality carbohydrates such as fresh fruit. Apples, berries, pears, grapes, and oranges all have sweet, juicy flavors and are packed with fiber to help slow the absorption of glucose, making them a much better choice for blood sugar control. When snacking on fruit, pair it with a protein food, such as a string cheese, nonfat yogurt, or handful of nuts, to further reduce the impact on your blood sugar. [v]

 Fruit Juice

While whole fruits are a healthy, fiber-rich carbohydrate option for diabetics, the same can’t be said for fruit juice. They may offer more nutritional benefit than soda and other sugary drinks, but fruit juices — even 100 percent fruit juices — are chock full of fruit sugar, and therefore cause a sharp spike in blood sugar. Skipping the glass of juice and opting for the fiber-packed whole fruit counterpart will help you maintain healthy blood sugar levels and fill you up on fewer calories, aiding in weight loss. For a refreshing and healthy drink alternative, choose zero-calorie plain or naturally-flavored seltzer and jazz it up with a wedge of lemon or lime. [v]

Raisins

Eating raisins or other dried fruits may be a better option than snacking on cookies, but it’ll still spike your blood sugar. Why? During the dehydration process, fruits’ natural sugars become very concentrated, causing an unhealthy elevation in blood sugar when they are rapidly absorbed by the body. Just one more reason to stick with whole, fresh fruit options like grapefruit, cantaloupe, strawberries, and peaches. [v]

Pancakes & Syrup

A plate of pancakes with syrup is a total carb explosion and one of the absolute worst breakfast choices for someone with diabetes. Most pancakes are jumbo-sized and made with junky white flour, so downing a stack of three large flapjacks can be the equivalent of eating seven slices of white bread! Of course, the toppings make matters worse. Butter is loaded with artery-clogging saturated fat, and a typical half-cup pour of gooey pancake syrup adds 16 teaspoons of straight sugar to your breakfast! This starch-and-sugar overload will send your blood sugars into a tailspin (not to mention, help you pack on the pounds). Next time you’re at a diner, bypass the pancakes and instead order a low-carb, protein-rich egg white omelet stuffed with vegetables. [v]

French Fries

Overdoing it on greasy, fried foods can lead to weight gain and wreak havoc on your blood sugar. French fries, potato chips, and doughnuts are particularly bad choices for diabetics because they’re made with carb-heavy, starchy ingredients, which can cause blood glucose levels to shoot up. Fried foods soak up tons of oil, leading to lots of extra calories — and some, like fried chicken and many fried appetizers, are coated in breading which increases the calorie count even more. Many fried foods are also laden with unhealthy trans fats because they’ve been deep-fried in hydrogenated oils, which will raise your bad cholesterol and increase your risk of heart disease. Whether you already have diabetes or are working to prevent it, no amount of trans fats can be safely incorporated into your diet, so it’s best to check labels and keep hydrogenated oils far from your plate. [v]

White Bread

Refined starches — white bread, white rice, white pasta, and anything made with white flour — act a lot like sugar once the body starts to digest them. Therefore, just like sugar, refined starches interfere with glucose control and should be avoided by those with diabetes. Whole grains are a better choice because they’re richer in fiber and generally cause a slower, steadier rise in blood sugar. Instead of white bread or a bagel for breakfast, opt for a toasted whole grain English muffin (topped with a slice of reduced-fat cheese or scrambled egg for protein). At lunch and dinner, replace white carbs with healthier whole grain options such as brown or wild rice, barley, quinoa, and whole-wheat bread to minimize the impact on your blood sugar. Even high-quality, whole grain starches elevate blood glucose to some degree, so it’s still important to limit portions — stick with ½ to ¾ cup cooked grains or just 1 slice of bread at meals. [v]

Whole Milk

Saturated fats in dairy products have racked up a laundry list of negative side effects including raising “bad” (LDL) cholesterol and promoting inflammation throughout the body. But for those with diabetes, a diet high in saturated fat can cause another serious problem: Studies have shown that saturated fats can worsen insulin resistance. Keep whole milk out of the fridge, and pick up 1% low-fat or skim milk instead. Also, try your best to avoid whole-milk dairy products like cream, full-fat yogurt, regular cheese and cream cheese; instead, choose their reduced-fat counterparts whenever possible. [v]

Bacon

In addition to whole-fat dairy foods, fatty or marbled cuts of meat also carry a hefty amount of saturated fat, which initiates inflammation in the body and raises cholesterol levels. Since those with diabetes are already at an increased risk of heart disease, eating high-fat meats puts them at an even greater risk of heart disease than the average person. Instead of feasting on fatty bacon, hamburgers, bologna, hot dogs, or spare ribs, fill your plate with lean protein choices like skinless chicken and turkey, fish and shellfish, or lean pork tenderloin. [v]

Snack Cakes & Pastries

It’s common knowledge that packaged snacks and baked goods are loaded with sugar, sodium, junky white flour and preservatives. Their dangerous combo of sugar and refined flour spikes blood sugar and promotes inflammation, which interferes with insulin’s ability to function properly. If that isn’t enough to turn you away from the vending machine, you should know that these highly-processed sweet treats often contain trans fats. These toxic fats raise your cholesterol and risk of heart disease, and are by far the most dangerous of fat types for diabetics. Check labels carefully; always choose packaged products that list 0 grams trans fat and do not include any partially hydrogenated oils (a major source of trans fats) on the ingredients panel. By ditching these packaged desserts, you’ll save calories and cash and get a better handle on your blood sugar control. [v]

Pretzels

Pretzels have a healthy image, but a glance at the ingredients list reveals that their wholesome reputation is grossly undeserved. Nearly every brand is made from the same basic ingredients: white flour (wheat flour that’s been stripped of its nutrients and fiber), yeast, salt, and maybe some vegetable oil or corn syrup. It’s obvious from its subpar ingredient list that this popular snack is pretty much devoid of nutrition. Pretzels are baked, not fried like potato chips, which saves you a few calories, but the white, refined carbs do a number on your blood sugar and do little to satisfy your appetite. Skip the carb-fest and opt for a more balanced and filling snack that includes some protein to help steady your sugars. Great choices include a rice cake with reduced-fat cheese, a handful of pistachio nuts in the shell, or a nonfat Greek yogurt. [v]

[i] http://nihseniorhealth.gov/diabetes/diabetesdefined/01.html

[ii] http://www.homeinstead.com/senior-care-resources-illnesses-conditions/diabetes/pages/diabetes-care.aspx

[iii] http://www.homeinstead.com/senior-care-resources-illnesses-conditions/Diabetes/Pages/impactofdiabetes.aspx

[iv] http://www.care.com/senior-care-caring-for-seniors-with-diabetes-p1143-q317305.html

[v] http://www.joybauer.com/photo-gallery/worst-foods-for-diabetes.aspx

Written by Valerie Michel Buck

 Visiting Angels is a member of  The National Care Planning Council (NCPC), an organization dedicated to helping families recognize the need for long term care planning. More information is available at www.longtermcarelink.net.

~ Lori

Lori Holmgren RN, MSN