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The risk of developing diabetes increases as people grow older, heavier and less active; about 20 percent of the population between the ages of 60 and 74 has diabetes. Older individuals with diabetes are at much greater risk of developing complications such as heart disease, stroke, cognitive impairment and functional disability.
While the goals of treatment for older diabetics – reducing vascular complications and preventing hyperglycemia – are similar to those for younger diabetics, there are important differences. Strict blood-sugar control can reduce complications from diabetes, however the elderly are at increased risk for hypoglycemia, which can lead to falls and brain injury. Thus, the goals for glucose lowering in elderly patients are less stringent than in younger patients. Older diabetics also are more likely to be on multiple medications for other conditions, and greater care must be taken when selecting and using medications to treat their diabetes. Heart failure and renal disease are also more common among older patients, and these conditions limit the safety and usefulness of certain diabetes medications. It is important for older diabetics to work closely with health professionals to choose the right treatments and to monitor the effects.
The mainstays of both prevention and treatment for diabetes are diet and exercise. Older patients who are overweight can often reduce the need for medication and in some cases eliminate diabetes medication altogether with careful and continuous attention to diet and exercise. Even modest weight reduction can reduce the need for medication. A daily walk for at least 30 minutes can be as effective as some medications to help control blood sugar. Maintaining regular sleep habits also is important; a recent study suggested that insufficient sleep can contribute to the development of diabetes.
So while we look forward to the holidays and all the opportunities to enjoy being with our friends and family, let’s also be aware of Diabetes Awareness Month and use this time to think about our lifestyle choices and what changes we can make to promote good health, including attention to diet, regular exercise and a good night’s sleep.