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Type 2 Diabetes in the Older Adult


What you need to know if you are an older adult with diabetes:

The risk for type 2 diabetes increases as a person gets older. Type 2 diabetes means your pancreas does not make enough insulin, or your body does not use insulin well. Insulin helps move sugar out of the blood so it can be used for energy. Diabetes cannot be cured, but it can be managed.


Call or have someone close to you call your local emergency number (911 in the US) 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
    • You may also have any of the following:
      • Discomfort or pain in your back, neck, jaw, stomach, or arm
      • Shortness of breath
      • Nausea or vomiting
      • Lightheadedness or a sudden cold sweat

Seek care immediately if:

  • Your blood sugar level is higher than your goal and does not come down with treatment.
  • You have signs of a high blood sugar level, such as blurred or double vision.
  • You have signs of a high ketone level, such as fruity, sweet smelling breath, or shallow breathing.
  • You have symptoms of a low blood sugar level, such as trouble thinking, sweating, or a pounding heartbeat.
  • Your blood sugar level is lower than normal and does not improve with treatment.

Call your doctor or diabetes care team 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 diabetes, 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.

Diabetes education:

Diabetes education will start right away, if the diagnosis is new. You may need diabetes education at a later time to refresh your memory. Members of your care team can help you, your family, and caregivers with a plan for the following:

  • How to check your blood sugar level: You will learn when to check your blood sugar level and what the level should be. You will learn what to do if your level is too high or too low. Write down the times of your checks and your levels. Take them to all follow-up appointments.
    How to check your blood sugar
  • About diabetes medicine: Oral diabetes medicine may be given to help control your blood sugar levels. Your healthcare provider will teach you how and when to take your diabetes medicine. You will also be taught when not to take the medicine. You will also be taught about side effects oral diabetes medicine can cause.
  • If you need insulin: Insulin may be added if oral diabetes medicine becomes less effective over time. You and your family members will be taught how to draw up and give insulin, if needed. You will learn how much insulin you need and what time to inject insulin. You will be taught when not to give insulin. You will also be taught what to do if your blood sugar level drops too low. This may happen if you take insulin and do not eat the right amount of carbohydrates. Your team will also teach you how to dispose of needles and syringes.
  • About nutrition: A dietitian will help you make a meal plan to keep your blood sugar level steady. You will learn how food affects your blood sugar levels. You will also learn to keep track of sugar and starchy foods (carbohydrates). Do not skip meals. Your blood sugar level may drop too low if you have taken insulin and do not eat.
  • How to prevent complications: Diabetes that is not well controlled can lead to health problems. Examples include foot sores, retinopathy (vision loss), and peripheral neuropathy (loss of feeling in your hands and feet). Also, risk for dementia can increase when blood sugar levels that are too high or too low for long periods of time. Your team will help you know when to get regular checkups, such as vision checks. They will teach you how to watch for problems and when to get a problem checked.

Manage diabetes and prevent problems:

Sometimes type 2 diabetes can be managed with changes in nutrition and physical activity.

  • Work with your diabetes care team to create plans to meet your needs. Your diabetes care team may include a physician, nurse practitioner, and physician assistant. It may also include a diabetes nurse educator, dietitian, and an exercise specialist. Family members, or others who are close to you, may also be part of the team. You and your team will make goals and plans to manage diabetes and other health problems. For example, the plan will include how to manage medicines you may take for diabetes and for other health conditions. The plans and goals will be specific to your needs and abilities. Your plan will change as your needs and abilities change.
  • Manage other health issues as directed. Health issues may include high blood pressure, high cholesterol levels, and heart problems. Health issues may also include depression. Together you and your care team can create a plan to manage any other health issues.
  • Try to be physically active for 30 to 60 minutes most days of the week. Physical activity, such as exercise, helps keep your blood sugar level steady and lowers your risk for heart disease. Physical activity can help improve your balance and strength and lower your risk for falls. Start slowly. Activity can be done in 10-minute intervals.
    • Set a goal for 30 minutes of aerobic activity at least 5 times a week. Aerobic activity helps your heart stay strong. Aerobic activity includes walking, bicycling, dancing, swimming, and raking leaves.
      Water Aerobics for Seniors
    • Set a goal for strength training 2 times a week. Strength training helps you keep the muscles you have and build new muscles. Strength training includes lifting weights, climbing stairs, and doing yoga or tai chi.
      Strength Training for Seniors
    • Stay steady on your on your feet with balancing activities. These include walking backwards, standing on one foot, and walking heel to toe in a straight line.
      Balance on 1 Foot
  • Maintain a healthy weight. Ask your provider what a healthy weight is for you. A healthy weight can help you control diabetes and prevent heart disease. Ask your provider to help you create a weight loss plan if you are overweight. Weight loss of 10 to 15 pounds can help make a difference in managing diabetes. Together you and your care team can set manageable weight loss goals.
  • Know the risks if you choose to drink alcohol. Alcohol can cause your blood sugar levels to be low if you use insulin. Alcohol can cause high blood sugar levels and weight gain if you drink too much. Women 21 years or older and men 65 years or older should limit alcohol to 1 drink a day. Men 21 to 64 years should limit alcohol to 2 drinks a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.
  • Do not smoke. Nicotine and other chemicals in cigarettes can cause lung disease and other health problems. It can also cause blood vessel damage that makes diabetes more difficult to manage. 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.

Other ways to manage 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.
    Diabetic Foot Care
  • Wear medical alert identification. Wear medical alert jewelry or carry a card that says you have type 2 diabetes. Ask your healthcare provider where to get these items.
    Medical Alert Jewelry
  • Ask about vaccines. You have a higher risk for serious illness if you get the flu, pneumonia, COVID-19, or hepatitis. Ask your healthcare provider if you should get a flu, pneumonia, shingles, or hepatitis B vaccine, and when to get the COVID-19 vaccine.
  • Get help from family and friends. You may need help checking your blood sugar level, giving insulin injections, or preparing your meals. You may also need help to check your feet for sores. Ask your family and friends to help you with these tasks. Talk to your care team if you need someone at home to help you.

Follow up with your doctor or diabetes care team as directed:

You will need to return to meet with different care team members. You may need tests to monitor for problems. Write down your questions so you remember to ask them during your visits. Talk to your care team or doctor if you cannot afford your medicine.

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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.

Further information

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