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Diabetes In The Older Adult

WHAT YOU NEED TO KNOW:

Older adults with diabetes are at risk for heart disease, stroke, kidney disease, blindness, and nerve damage. You may also be at risk for any of the following:
  • Poor nutrition or low blood sugar levels
  • Confusion or problems with memory, attention, or learning new things
  • Trouble controlling urination or frequent urinary tract infections
  • Trouble with coordination or balance
  • Falls and injuries
  • Pain
  • Depression
  • Open sores on your legs or feet

DISCHARGE INSTRUCTIONS:

Call 911 for any of the following:

  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss
  • You have any of the following signs of a heart attack:
    • Squeezing, pressure, or pain in your chest that lasts longer than 5 minutes or returns
    • Discomfort or pain in your back, neck, jaw, stomach, or arm
    • Trouble breathing
    • Nausea or vomiting
    • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing

Return to the emergency department if:

  • You have severe abdominal pain, or the pain spreads to your back. You may also be vomiting.
  • You have trouble staying awake or focusing.
  • You are shaking or sweating.
  • You have blurred or double vision.
  • Your breath has a fruity, sweet smell.
  • Your breathing is deep and labored, or rapid and shallow.
  • Your heartbeat is fast and weak.
  • You fall and get hurt.

Contact your healthcare provider if:

  • You are vomiting or have diarrhea.
  • You have an upset stomach and cannot eat the foods on your meal plan.
  • You feel weak or more tired than usual.
  • You feel dizzy, have headaches, or are easily irritated.
  • Your skin is red, warm, dry, or swollen.
  • You have a wound that does not heal.
  • You have numbness in your arms or legs.
  • You have trouble coping with your illness, or you feel anxious or depressed.
  • You have problems with your memory.
  • You have changes in your vision.
  • You have questions or concerns about your condition or care.

Medicines

may be given to decrease the amount of sugar in your blood. You may also need medicine to lower your blood pressure or cholesterol, or medicine to prevent blood clots.

Manage the ABCs and prevent problems caused by diabetes:

  • Check your blood sugar levels as directed. Your healthcare provider will tell you when and how often to check during the day. Your healthcare provider will also tell you what your blood sugar levels should be before and after a meal. You may need to check for ketones in your urine or blood if your level is higher than directed. Write down your results and show them to your healthcare provider. Your provider may use the results to make changes to your medicine, food, or exercise schedules. Ask your healthcare provider for more information about how to treat a high or low blood sugar level.
    How to check your blood sugar
  • Follow your meal plan as directed. A dietitian will help you make a meal plan to keep your blood sugar level steady and make sure you get enough nutrition. Do not skip meals. Your blood sugar level may drop too low if you have taken diabetes medicine and do not eat. Ask your healthcare provider about programs in your community that can deliver the meals to your home.
  • Try to be active for 30 to 60 minutes most days of the week. Exercise can help keep your blood sugar level steady, decrease your risk of heart disease, and help you lose weight. It can also help improve your balance and decrease your risk for falls. Work with your healthcare provider to create an exercise plan. Ask a family member or friend to exercise with you. Start slow and exercise for 5 to 10 minutes at a time. Examples of activities include walking or swimming. Include muscle strengthening activities 2 to 3 days each week. Include balance training 2 to 3 times each week. Activities that help increase balance include yoga and tai chi.
  • Maintain a healthy weight. Ask your healthcare provider how much you should weigh. A healthy weight can help you control your diabetes and prevent heart disease. Ask your provider to help you create a weight loss plan if you are overweight. Together you can set manageable weight loss goals.
  • Do not smoke. Ask your healthcare provider for information if you currently smoke and need help to quit. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine.
  • Manage stress. Stress may increase your blood sugar level. Deep breathing, muscle relaxation, and music may help you relax. Ask your healthcare provider for more information about these practices.

Other ways to manage your diabetes:

  • Check your feet every day for sores. Look at your whole foot, including the bottom, and between and under your toes. Check for wounds, corns, and calluses. Use a mirror to see the bottom of your feet. The skin on your feet may be shiny, tight, dry, or darker than normal. Your feet may also be cold and pale. Feel your feet by running your hands along the tops, bottoms, sides, and between your toes. Redness, swelling, and warmth are signs of blood flow problems that can lead to a foot ulcer. Do not try to remove corns or calluses yourself.

  • Wear medical alert identification. Wear medical alert jewelry or carry a card that says you have diabetes. Ask your healthcare provider where to get these items.
    Medical alert ID bracelet
  • Ask about vaccines. You have a higher risk for serious illness if you get the flu, pneumonia, or hepatitis. Ask your healthcare provider if you should get a flu, pneumonia, shingles, or hepatitis B vaccine, and when to get the vaccine.
  • Keep all appointments. You may need to return to have your A1c checked every 3 months. You will need to return at least once each year to have your feet checked. You will need an eye exam once a year to check for retinopathy. You will also need urine tests every year to check for kidney problems. You may need tests to monitor for heart disease. Write down your questions so you remember to ask them during your visits.
  • Get help from family and friends. You may need help checking your blood sugar level, giving insulin injections, or preparing your meals. Ask your family and friends to help you with these tasks. Talk to your healthcare provider if you do not have someone at home to help you. A healthcare provider can come to your home to help you with these tasks.

Follow up with your healthcare provider as directed:

You may need to return to have your A1c checked every 3 months. You will need to return at least once each year to have your feet checked. You will need an eye exam once a year to check for retinopathy. You will also need urine tests every year to check for kidney problems. You may need tests to monitor for heart disease. Write down your questions so you remember to ask them during your visits.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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