Tips for Controlling Type 2 Diabetes

Older adults often experience chronic health conditions, in part because of a combination of lifestyle habits and the aging process. Type 2 diabetes is a very common chronic health problem in older adults. As many as 33% of adults age 65 and older have this diagnosis. 1 Controlling type 2 diabetes is critical to your overall health.

If your doctor has told you that you are pre-diabetic or have type 2 diabetes, there are ways you can improve your health and reduce your risk of complications due to diabetes. It requires commitment and new healthy habits, but with consistent effort, you can live a full and active life.

What is type 2 diabetes?

In type 2 diabetes, the pancreas, which is responsible for making insulin, does not do it well. Usually, in response to blood sugar increases, insulin is released to control these spikes. With type 2 diabetes, blood sugar remains too high. This can cause several complications, some of them serious.

Older adults are at higher risk of diabetes due to a combination of changes in the pancreas due to aging, as well as inactivity and sometimes, being overweight. 2

Symptoms of type 2 diabetes

Type 2 diabetes can develop slowly, and it’s easy to overlook symptoms or dismiss them as part of getting older. The Centers for Disease Controls (CDC) lists the following symptoms: 3

Increased thirst
Frequent urination, especially at night
Increased hunger
Losing weight without trying to
Blurry vision
Dry skin
Fatigue
Numbness and tingling in the hands or feet
Sores that heal slowly
More frequent infections than usual

Complications of type 2 diabetes

Type 2 diabetes is known to cause several other health complications. Because it can be overlooked for some time before it’s discovered, sometimes these complications are already happening when type 2 diabetes is diagnosed.

These complications are linked to type 2 diabetes: 4

Blindness
Kidney failure
Non-traumatic amputation of toes, feet, or legs
Heart disease
Stroke
Nerve damage
Decreased blood flow
Risk of death due to extremely high blood sugar (hyperglycemia) or extremely low blood sugar (hypoglycemia)

Older adults especially are at higher risk of these common complications. They have the highest rates of lower extremity amputation, heart attack, end-stage kidney disease, visual impairment, and death of any age group with diabetes. 5

Overall, diabetes is a leading cause of death in the United States, ranked number 7 in 2019. 6

Treating and controlling type 2 diabetes

Controlling type 2 diabetes involves a combination of lifestyle changes and medical care. These steps aren’t always easy to take, but the result of sticking with them is worth it. There are three key areas to focus on to control your diabetes: physical activity, diet, and following your doctor’s recommendations.

Increase your physical activity

The American Diabetes Association (ADA) states that regular physical activity is critical for blood glucose control and overall health for people with diabetes, and reduces A1C (a measure of blood glucose control), cholesterol, blood pressure, and insulin resistance. 7 Their exercise recommendations for type 2 diabetes include:

Daily exercise, or at least not skipping more than 2 days of exercise
A combination of aerobic and resistance training is best
At least 150 minutes per week of physical activity

You can work with your doctor on the best exercise options for you. Walking, yoga, swimming, water aerobics, and other similar activities can be a regular part of your routine. If you have physical limitations, these activities can be modified for you, such as using chair yoga.

Along with improving diabetes, there are other benefits to exercise, too: the ADA found that group exercises like resistance and balance training, and tai chi classes, can reduce falls by 28%−29%. 8

Practice balanced eating

The ADA recommends following the Diabetes Plate method to help control your diabetes: ½ of your plate should be non-starchy (high fiber) vegetables, ¼ should be a protein choice, and ¼ carbohydrates, with water as a drink.9

Fiber, protein, and healthy fats (like poly and monounsaturated fats) all help to keep you full for longer and have less impact on your blood sugar. Some “superstar” foods recommended by the ADA include: 10

Beans
Dark leafy green vegetables
Citrus fruit
Berries
Tomatoes
Fish high in omega-3 fatty acids
Nuts
Whole grains
Milk and yogurt

If you’re overweight, the combination of exercise and healthy eating can help you achieve weight loss, which has been shown to reduce rates of diabetes in people with pre-diabetes, and in some cases can even help people with diabetes achieve remission. 11,12

Follow your doctor’s recommendations

Along with diet and exercise, one of the most important parts of controlling type 2 diabetes is working closely with your doctor and following their recommendations. They will check things like your blood pressure, cholesterol, and blood sugar levels and suggest medications like insulin as needed to help control any problems.

Know your hemoglobin A1C

This blood test is crucial to controlling type 2 diabetes. It is a measure of how well blood sugar has been controlled over time. For people who have not been diagnosed with diabetes, it is an important test to screen for undetected diabetes.

A normal A1C is 5.7% or below, and the goal for people with diabetes is less than 7%. The CDC recommends having your A1C checked twice yearly if you have diabetes. 13

Recognizing an emergency due to diabetes

Two basic emergencies can happen due to diabetes: hyperglycemia and hypoglycemia. In these situations, blood sugar either becomes dangerously high or dangerously low. Untreated, they can lead to coma and death.

Signs of hyperglycemia

Hyperglycemia involves blood sugar that is too high. This can happen because someone has not taken enough insulin, has eaten too much sugar, or during illness. Symptoms of hyperglycemia include: 14

Warm, dry skin
Dry mouth
Rapid breathing or heartbeat
Fruity, sweet breath
Excessive thirst
Vomiting
Abdominal pain
Drowsiness, confusion, or unresponsiveness

If you suspect hyperglycemia, check your blood sugar and follow any instructions your doctor has given you for insulin dosing for high blood sugar. If your blood sugar remains high, or if a person in your care with diabetes is confused or drowsy, seek medical care right away.

Signs of hypoglycemia

Hypoglycemia involves blood sugar that is too low. When blood sugar falls below 70 mg/dl, you must take action. The CDC recommends following the 15/15 rule: 15

For blood sugar between 55-69 mg/dl, consume 15 grams of carbs and recheck blood sugar in 15 minutes. Examples of carbs include 3-4 glucose tablets, 4 oz. of juice or regular soda, 1 tablespoon of sugar, honey, or syrup, 1 dose of glucose gel (usually 1 tube), or hard candies or jelly beans (follow the label for the amount that equals 15 grams).

For blood sugar below 55 mg/dl, injectable glucagon can help correct the low blood sugar. This comes in a prescription kit, and your medical team will have to give you instructions and training on its use. It’s also important that caregivers know how to use this injection, since you might not be able to treat yourself if your blood sugar falls this low.

When in doubt, call 911. It’s also important to wear a medical ID so that first responders are aware of your diabetes if an emergency happens and you can’t relay important details to them.

Symptoms of hypoglycemia include: 16

Fast heartbeat
Shaking
Nervousness or anxiety
Irritability or confusion
Sweating
Dizziness
Hunger

Well-controlled type 2 diabetes is possible

By following the above recommendations, and maintaining an A1C below 7%, your risk of long-term complications due to diabetes will be greatly decreased. One way you can have success with this is to involve your family and caregivers in your lifestyle change goals.

Family and professional caregivers can help you prepare healthy meals, get regular activity, take your medications as directed, and attend regular doctor’s appointments.

If you’ve been considering in-home care as a way to help you manage your diabetes and other health concerns, Caresify can work with you to provide care that meets your needs at home. You can read more here, or call 888-799-5007.

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