For many seniors, diabetes is avoidable and treatable

Linda Margiloff, M.D.

Diabetes has traditionally been viewed as a senior citizen’s disease. Although incidents of type 2 diabetes among teenagers have climbed steadily in recent years, the disease still afflicts the elderly in great numbers. In fact, of the nearly 21 million Americans with diabetes, 40 percent are 65 years old or older — and according to the American Geriatrics Society, that percentage is expected to increase in the coming years.

The health problems that diabetes presents to seniors are considerable. People with the disease are more likely to suffer from blocked arteries, nerve damage, loss of vision, kidney disease and loss of limbs. The rates of heart attack, stroke, kidney failure and blindness are twice as high in older adults with diabetes. And if you are African American, Native American or Hispanic, you are twice as likely to get the disease.

While these facts sound grim, the news isn’t all bad. In fact, even if you are in one of these high-risk groups, there is a lot that you can do to prevent diabetes. And if you are diagnosed with the disease, it can be treated effectively by a combination of lifestyle changes and medication.

The first step: Diagnosis

If you are worried that you may have diabetes, or that you may be at risk, the first thing you should do is look at your risk factors.

Are you African American, Native American or Hispanic? Is there a history of diabetes in your family? Are you overweight? Are you habitually inactive? If you answered yes to any of these questions, you should evaluate your own health to see if you have any of the symptoms that are common among diabetics.

There are 10 primary symptoms to uncontrolled diabetes: increased thirst; increased or excessive urination; unexplained weight loss; fatigue; loss of vitality; wounds that are slow to heal; foot sores; numbness or tingling in the feet; confusion; and depression.

Obviously, the presence of one or more of these isn’t a guarantee that you have diabetes. However, these symptoms are clear indicators that you may be at risk, and if you have them you should see your doctor immediately. With a simple blood sugar test, your doctor can determine whether you have diabetes or are at risk for the disease.

Even if you don’t have these symptoms, you should be checked out regularly — in fact, everyone over 45 should be tested every three years, and if you are a member of a high-risk group, you may need to be checked even more frequently. You should also continue to examine yourself, keeping an eye out for symptoms. Most people don’t learn that they have diabetes until the disease has advanced to the point where there is already damage, so it is important to regularly check for warning signs.

The next step: Treatment

If you do have diabetes or are pre-diabetic, there are a number of things you can do to improve your health. When it comes to medication, the days when everyone with diabetes had to be injected with regular doses of insulin are over. Today, there are a number of different drugs that can be used to control diabetes.

It is equally important for you to speak with your doctor about the other risks that are associated with diabetes, such as heart disease and stroke. Make sure that your doctor is addressing these risks as well.

As important as medical treatment is, though, the most important thing you can do is change your lifestyle — and your doctor can even help with this. Find out whether your doctor’s team has a diabetic educator who can provide information about diabetes, as well as the lifestyle changes that can help you control your diabetes.

The most effective lifestyle change for people with diabetes is losing weight. Losing just 7 percent of your body weight can significantly cut diabetes-related risks. That may seem like a lot, but for a person weighing 200 pounds, 7 percent equals a loss of only 14 pounds.

Diet is a key to living a healthy life, but unfortunately the American lifestyle isn’t always conducive to maintaining a healthy diet. And of course, it’s not realistic to ask people to give up foods they’ve grown to love, like red meat and breads. However, you can significantly reduce your risk by consuming less healthy foods in moderation. Rather than eating red meat three or four times a week, try cutting back to once or twice and substituting more fish, veal or chicken.

In fact, even healthy foods should be eaten in moderation. Our metabolism slows over time, and as we get older we need less food to survive. Portion control is vital, no matter how healthy our food choices are.

Another excellent way to improve your health is to eat with others, because people tend to eat better in a social environment. Senior centers and churches often offer excellent opportunities to eat healthy meals with other seniors.

Of course, being healthy involves more than just your diet. You can also cut your diabetes risk by becoming more active. Evaluate your current level of exercise and increase the amount by as much as you feel you can handle. And if you smoke, quit now. Smoking is another huge lifestyle factor that can lead to diabetes or complicate the condition of people who have the disease.

Finally, it is essential for all diabetes patients to monitor their blood sugar every day — it isn’t enough to just pay attention to how you feel. It is common for people with diabetes, particularly those in the early stages of the disease, to feel perfectly fine. If you have diabetes, you should work with your medical team to develop a plan of response in case your blood sugar levels do become abnormal.

Diabetes has practically become an epidemic in recent years, particularly among seniors. However, you can significantly cut your risk for diabetes and other related health issues if you keep a close watch on your symptoms and adopt a healthier lifestyle. Diabetes is more avoidable and manageable than ever before. You just need to be aware of the risks and take the necessary steps to avoid them.

Linda Margiloff, M.D., is an endocrinologist practicing at Radius Specialty Hospital in Roxbury.