How Meaningful Is Prediabetes For Older Adults
A new study indicates that the condition might be less of a worry than once believed.
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By Paula Span
A few years ago, routine lab tests showed that Susan Glickman Weinberg, then a 65-year-old clinical social worker in Los Angeles, had a hemoglobin A1C reading of 5.8 percent, barely above normal.
This is considered prediabetes, her internist told her. A1C measures how much sugar has been circulating in the bloodstream over time. If her results reached 6 percent still below the number that defines diabetes, which is 6.5 her doctor said he would recommend the widely prescribed drug metformin.
The thought that maybe Id get diabetes was very upsetting, recalled Ms. Weinberg, who as a child had heard relatives talking about it as this mysterious terrible thing.
She was already taking two blood pressure medications, a statin for cholesterol and an osteoporosis drug. Did she really need another prescription? She worried, too, about reports at the time of tainted imported drugs. She wasnt even sure what prediabetes meant, or how quickly it might become diabetes.
I felt like Patient Zero, she said. There were a lot of unknowns.
Now, there are fewer unknowns. A longitudinal study of older adults, published online this month in the journal JAMA Internal Medicine, provides some answers about the very common in-between condition known as prediabetes.
Sixteen to 19 percent had died, about the same proportion as those without prediabetes.
Care Measures For The Diabetic Seniors
High and low blood sugar in seniors with diabetes can be hazardous and cause serious complications. As a result, these people need special care.
People with diabetes in old age have been able to prevent diabetes in previous years by following a diet, proper nutrition in seniors with diabetes, and regular physical activity. Taking these steps when a person has diabetes can be effective in controlling blood sugar levels.
Excess sugar in seniors, especially women, causes urinary tract infections. If you feel that urine smell is unpleasant and intense, know that you need specific medications that a doctor must prescribe.
Another concern that you should be aware of is vision problems. Many people wear glasses as they get older, and their vision decreases. But this loss of vision is more dangerous in people with diabetes and requires more care. As blood sugar levels rise in people with diabetes, so does the pressure inside the eye. The result of these factors is a severe reduction in vision in people.
It has been observed that some people with diabetes have been forced to have their limbs amputated. Infections and wounds do not heal well in people with diabetes. These sores become infected and will gradually spread throughout the body. Seniors should pay attention to any sign of infection in their feet because it can lead to severe consequences.
Seniors should regularly have their blood sugar checked and take their medicine on time to prevent deterioration of diabetes symptoms.
Regularly Check Blood Glucose Levels
Running blood tests regularly at the lab or home is essential for monitoring and controlling diabetes in the elderly. Both very high or very low blood glucose levels can pose risks to the patients health.
Testing the percentage of A1C in the blood should be done at least twice a year. Even if the patients dont control their diabetes well but managed to put their blood glucose level within the reference ranges for routine testing, the A1C test will show it.
A normal A1C for elderly people is between 7% and 7.5%, and it demonstrates the patient has had good glycemic control for the past three months. These values are associated with a negligible risk of all-cause mortality in patients with diabetes.
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What Is The Normal Range Of Blood Sugar
Answered by: Dr Eesh bhatia | Professor in Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow Q: I am using “One touch Basic” machine for testing blood sugar level from Lifescan . I would like to know the normal range of sugar level for Fasting and PP on this machine. A:The normal values are the following: Fasting: 70-120 mg% Post prandial: 100-180 mg% The levels would vary with the individual situation for example we would maintain higher levels in a young child or in very elderly lower levels in pregnant women.Continue reading > >
Ways Older People Can Manage Their Diabetes To Stay Healthier
Diabetes is often a life-long condition and requires careful treatment. By sticking to your meal plan changes, exercise, and medication plan, you can live a long and healthy life. To help older people with diabetes to stay health and active are the following tips.
Eat HealthyAll people with diabetes should eat a healthy diet that is low in sugar and saturated fats. It may help to see a registered dietitian nutritionist who is a diabetes educator to help you create a healthy meal plan. Medicare will cover the visits every year so you would not have to pay out of pocket for the visit.
Stay ActiveAerobic exercise such as walking, swimming, and bicycling can help you control your glucose level, manage your weight, and stay strong. The American Diabetes Association recommends exercising 30 minutes each day, at least 5 days a week.
You can split up the exercise into 10-minutes of activity 3 times a day. In addition, do strength training such as free weights, resistance bands, or yoga, at least 2 times per week. Strength training builds muscle and helps control glucose levels. Talk to your healthcare professional to see what exercises are right for you.
Older people with diabetes are at higher risk of hypoglycemia when taking diabetes medications, making it especially important to check your glucose levels. Symptoms of hypoglycemia include confusion, dizziness, hunger, and sweating.
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Which Is Right For You
Finding the best glucose monitoring system that is right for you is about finding the choice that best suits your needs. By considering the benefits and limitations between the different systems that are available in Canada, you can find a system that meets your individual requirements while improving the efficiency and effectiveness of your diabetes care routine.
Our glucose monitoring comparison chart provides a summary of CGM, Flash glucose monitoring devices and test strips and meters.
Best Approach To Pharmacotherapy In Older Adults
Older adults with diabetes differ from their younger-adult counterparts in terms of glycemic goals and management of other cardiovascular risk factors. They also often have comorbidities and geriatric syndromes that interfere with self-care. It is crucial for providers to be aware of these differences to allow for proper assessment and to develop pharmacotherapeutic strategies that are adapted to unique challenges.
Lifestyle modification is important as the starting point for all patients with diabetes, including older adults. Although very restrictive diets are not recommended for older adults, counseling to avoid large carbohydrate loads at any one meal can reduce glucose excursions without unnecessary dietary restriction. Exercise is also important for all ages. It is important to consider patients physical abilities when developing an exercise plan. For example, older adults who are not very active and at risk of falls should be encouraged to walk for 510 minutes, two to three times per day, inside the house. The exercise program can be increased gradually as tolerated.
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Maintaining Healthy Blood Sugar Levels
- Eat a healthy breakfast containing fiber and protein within an hour of waking up to prevent hypoglycemia.
- Always eat healthy fats, protein, and fiber with each meal, as this slows the digestive process and the number of carbohydrates released into the bloodstream, keeping blood sugar levels stable.
- Exercise regularly to burn off extra blood sugar.
- Drink plenty of water and avoid sugary drinks, such as soda, sports drinks, and juice, as these quickly raise blood sugar levels.
- Keep a supply of hard candy, juice boxes, or glucose tablets on hand in case of low blood sugar crashes. If your loved one has hypoglycemia, he or she should consume a sugary snack or drink as soon as possible and then recheck his or her levels.
What Is The Normal Blood Sugar Level In Healthy And Diabetic People
- Fasting state: for healthy people , for diabetics
- Before lunch and dinner: for healthy people , for diabetics
- Up to 2 hours after meals: for healthy people , for diabetics
- Before bed: for healthy people , for diabetics
If a persons fasting blood sugar is between 100 and 125, he/she has pre-diabetes.
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The Importance Of Managing Diabetes In Older Adults
Fortunately, a diabetes diagnosis is not the end of the world. Taking control of blood glucose can prevent further problems.The family doctor can refer a diabetic senior to a specialistan endocrinologist. Once the patient has been diagnosed with diabetes, the doctor will choose the best treatment based on:
- the type of diabetes
- patients everyday routine
- patients additional health problems
Managing type 2 diabetes in the elderly can be very successful. Sometimes even a change in diet and exercise can control blood glucose levels within the reference ranges. Some patients, however, need medicines or insulin injections. The most critical strategies are healthy lifestyle changes and proper medication.
Normal blood sugar levels for elderly adults range from 100 mg/dL to 6070 mg/dL, depending on a laboratorys reference range. According to the 2018 Clinical Practice Guidelines of the American Diabetes Association , prediabetes is established when fasting blood glucose varies between 100125 mg/dL, whereas diabetes is diagnosed when fasting readings surpass 125 mg/dL. These numbers are the same for all adults, including seniors.
What Are Normal Blood Sugar Levels
You might want to measure your blood sugar before meals to get a baseline, and then two hours after your meal to measure your normal blood sugar level. Your doctor might also suggest measuring blood sugar before bed to be sure you have been eating well throughout the day and can go to sleep with peace of mind.
These are considered within the range of normal:
- Less than 140 mg/dl if you do not have diabetes.
- Less than 180 mg/dl if you have diabetes.
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Recommended Blood Sugar Targets For Most People With Diabetes*
Your targets may not be the same as the examples in this chart. Your targets are important and should be specific to you.
|4.0 to 7.0||5.0 to 10.0|
* This information is based on the Diabetes Canada 2018 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada and is a guide.** A1C is a measurement of your average blood sugar control for the last two to three months and approximately 50 per cent of the value comes from the last 30 days.
Maintain Proper Skin And Oral Hygiene
Minor cuts that are difficult to heal could be one of the first signs of geriatric diabetes. Any wounds or bruises have to be managed accordingly to prevent infections. Keeping skin clean and using skin softeners for dryness are the best ways to protect it. Senior patients also have to pay attention to the care of their teeth and gums. Brushing teeth and flossing keep the problems away.
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Urine Smells Sweet Not Diabetes
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Type 1 Seniors May Miss Spells Of Low Blood Sugar
FRIDAY, March 29, 2019 — When you have type 1 diabetes, keeping track of your blood sugar levels can be challenging. But new research suggests that seniors might really have trouble avoiding low blood sugar, or hypoglycemia.
In fact, many patients over age 60 may experience up to 100 minutes of a day with low blood sugar and not even know it, the study researchers said.
The bottom line: “Older adults with type 1 diabetes do spend a considerable amount of time in hypoglycemia,” said study author Dr. Anders Carlson. He’s medical director of the International Diabetes Center in Minneapolis.
“Hypoglycemia can lead to a lot of severe consequences — loss of consciousness, accidents, falls, hospitalizations and ER visits. Older adults have a higher risk from hypoglycemia in terms of arrhythmia that can result in higher cardiovascular problems,” Carlson explained.
“Hypoglycemia can take a toll on people. You have to be ready and able to treat hypoglycemia at any given moment,” he added.
Any blood sugar reading below 70 milligrams per deciliter is considered low blood sugar. When blood sugar drops below 54 mg/dL, you’re at risk for more serious symptoms.
The study looked at 203 adults older than 60 who had type 1 diabetes. More than 90 percent were white, and just over half wore an insulin pump. Their overall diabetes management averaged within the range recommended for older adults by the ADA.
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What Can I Do To Help Manage My Condition
Many different healthcare professionals are involved in the care of people with type 2 diabetes, but you are the most important member of your health care team. You can help get the most out of the health care system by getting involved in your own care and keeping your doctor or other healthcare professional informed of any issues. Let them know if you are having problems and they will try to help you.
Some of the things you can do are:
Remember, while untreated diabetes puts you at significant risk of a range of serious health problems, this risk can be vastly improved by getting diagnosed and getting appropriate medical and lifestyle treatment.
How Do I Check My Blood Glucose Levels
To check your blood glucose levels, you prick your finger with the lancet and add a small drop of blood onto a blood glucose checking strip. This strip is then inserted into the meter, which reads the strip and displays a number your blood glucose level.
When and how often you should check your blood glucose levels varies depending on each individual, the type of diabetes and the tablets and/or insulin being used. Blood glucose levels are measured in millimoles per litre of blood . Your doctor or Credentialled Diabetes Educator will help you decide how many checks are needed and the levels to aim for.
Keeping a record of your blood glucose levels can be very helpful for you and your doctor or Credentialled Diabetes Educator. You can keep a diary or use a mobile phone app or website to record your levels.
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Normal Blood Sugar Levels For Adults With Diabetes
Normally, your pancreas releases insulin when your blood sugar, or âblood glucose,â gets high — after a meal, for example. That signals your body to absorb glucose until levels get back to normal.
But if you have diabetes, your body doesnât make insulin or doesnât respond to it normally . That can leave your blood sugar too high for too long. Over time, that can damage nerves and blood vessels and lead to heart disease and other problems.
If you have diabetes, your doctor may ask you to keep track of your blood sugar by testing it at home with a special device called a blood glucose monitor or home blood sugar meter. It takes a small sample of blood, usually from the tip of your finger, and measures the amount of glucose in it.
Follow your doctorâs instructions about the best way to use your device.
Your doctor will tell you when and how to test your blood sugar. Each time you do it, log it in a notebook or online tool or in an app. The time of day, recent activity, your last meal, and other things can all affect whether a reading will be of concern to your doctor. So try to log relevant information like:
- What medication and dosage you took
- What you ate, when you ate, or whether you were fasting
- How much, how intense, and what kind of exercise you were doing, if any
That will help you and your doctor see how your treatment is working.
What Is Normal Blood Sugar In People Over 60
Glucose, derived from foods and body stores, is a main source of energy to the body. Some health conditions, most notably prediabetes and diabetes, are characterized by elevated levels of glucose or sugar in the blood, and blood sugar tests are used to screen for, and to monitor these disorders.
Blood sugar levels can also be checked at home, using a glucose meter or other devices. Normal ranges for laboratory blood sugar tests are the same for adults of all ages. However, recommended targets for home testing will sometimes be different for older adults.
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