Diabetes is a serious disease, and it affects such a large proportion of older adults that it is deemed the most common disease in people 65 years and older. People get diabetes when their blood glucose, also called blood sugar, is too high for a sustained period. The good news is that you can take steps to delay or prevent type 2 diabetes and if you already have diabetes, there are many ways you can manage the condition and prevent complex diabetes-related health problems.

Our bodies turn the food we eat into sugar, called glucose, which gives us energy. To use glucose as energy, our body needs insulin, a hormone that helps glucose get into our cells. If you have diabetes, your body either does not make enough insulin or does not use insulin in the right way, or both. As a result, too much glucose stays in the blood, and this is what causes health problems over time.

There are two main kinds of diabetes; type 1 (the body produces no insulin) and type 2 (the body does not make or use insulin properly).

Although older adults can develop type 1 diabetes, it begins most often in children and young adults, who then have diabetes for life. Conversely, Type 2 diabetes, which is the more common type, occurs most often in middle-aged and older adults. Your chance of getting type 2 diabetes is higher if you are overweight, inactive, or have a family history of diabetes. Women with a history of gestational diabetes (a type of diabetes that develops during pregnancy) also have a greater chance of developing type 2 diabetes later in life.

The management of diabetes is vital as the disease can affect many parts of your body if not properly controlled. Health problems related to diabetes include; heart disease, stroke, kidney disease, eye problems, and nerve damage that may lead to amputation. In addition, people with type 2 diabetes may be at greater risk for cancer and Alzheimer’s disease. Management of the disease is not terribly complicated but does require prioritisation and commitment.

Many people with type 2 diabetes can manage their blood glucose levels with diet and exercise alone. Others may need diabetes pills or insulin injections, along with medicines to manage other conditions like high blood pressure and high cholesterol. Over time, a person with diabetes may need both lifestyle changes and medication.

Here are some tips to stay healthy with diabetes:

• Get your blood pressure checked often.
• At least once a year, get a blood test to check your cholesterol and triglyceride levels. High levels may increase your risk of heart problems.
• Stop smoking. Smoking raises your risk for many health problems, including heart attack and stroke.
• Have annual eye exams. Finding and treating eye problems early may keep your eyes healthy.
• Get flu shots every year as well as the pneumonia vaccine. If you’re over 65, make sure you have had the pneumonia vaccine. Ask your doctor.
• Look at your feet. Take time to look at your feet every day for any red patches. Ask someone else to check your feet if you can’t. If you have sores, blisters, breaks in the skin, infections, or build-up of calluses, see a podiatrist.
• Keep up with cancer screenings. Ask your doctor which screenings to get based on your age, gender, and other risk factors.
• Talk with your doctor about your mental health concerns. If you think you might be depressed, are worried about your memory, or have any other concerns, talk with your doctor. There may be ways to help.

Prediabetes – What is this?

Pre-diabetes occurs when blood sugar levels are higher than normal, but not high enough to be considered diabetes. Over 5 million South Africans are currently sitting in this boat right now.  Most cases of pre-diabetes in South Africa go undiagnosed and this then leads to a greater chance of developing type 2 diabetes and having a heart attack or stroke. This is why it’s so vital to have your bloods checked.

If you have prediabetes, there are things you can do to prevent or delay getting type 2 diabetes. Losing weight may help. Healthy eating and being physically active can make a big difference. Work with your doctor to set up a plan to help you make healthier food choices and get regular exercise. Get help with quitting smoking (if you smoke), because smokers are more likely than nonsmokers to develop type 2 diabetes. Make sure to ask how often you should have your glucose levels checked. Your doctor may also talk with you about taking medication to delay or prevent type 2 diabetes.

Symptoms of Type 2 Diabetes

Symptoms of type 2 diabetes may include feeling tired, increased hunger or thirst, losing weight without trying, urinating often, or having trouble with blurred vision. You may also get skin infections or heal slowly from cuts and bruises. Some people with type 2 diabetes may not realise they have it because symptoms often develop slowly and go unnoticed. Sometimes older adults dismiss these symptoms as “getting old,” but they can be signs of a serious problem. Talk with your doctor if you have any of these symptoms.

The importance of exercise in managing and preventing Diabetes

Physical activity includes all movement that increases energy use, whereas exercise is planned, structured physical activity. Regular exercise may prevent or delay diabetes development as well as offer considerable health benefits. Exercise improves blood glucose control in type 2 diabetes, reduces cardiovascular risk factors, contributes to weight loss, and improves well-being, and increases insulin sensitivity.

Silver Fit’s Exercise Recommendations

• Daily exercise, or at least not allowing more than 2 days to elapse between exercise sessions, is recommended to enhance insulin action.
• Adults with type 2 diabetes should ideally perform both aerobic and resistance exercise training for optimal glycemic and health outcomes.
• Structured lifestyle interventions that include at least 150 min/week of physical activity and dietary changes resulting in a weight loss of 5%–7% are recommended to prevent or delay the onset of type 2 diabetes in populations at high risk and with prediabetes.

In addition, flexibility and balance exercise are important for older adults with diabetes. Limited joint mobility common in older adults and more so in diabetics. Stretching increases range of motion around joints and flexibility. Balance training can reduce falls risk by improving balance and gait, even when peripheral neuropathy is present. Group exercise classes (resistance and balance training) may reduce falls by 28%−29%.

Reducing sedentary time

Sedentary behaviour with low energy expenditure (TV viewing, desk work, etc.)—is sadly very common and has a significant influence on cardiometabolic health. Higher amounts of sedentary time are associated with increased mortality and morbidity.

In people with or at risk for developing type 2 diabetes, extended sedentary time is also associated with poorer blood glucose control.  Prolonged sitting interrupted by brief (≤5 min) bouts of standing or light-intensity ambulation every 20–30 min improves glycemic control in sedentary overweight/obese populations and in people with impaired glucose regulation.

• All adults, and particularly those with type 2 diabetes, should decrease the amount of time spent in daily sedentary behaviour.
• Prolonged sitting should be interrupted with bouts of light activity every 30 min for blood glucose benefits, at least in adults with type 2 diabetes.
• The above two recommendations are additional to, and not a replacement for, increased structured exercise.

Exercise is the best kind of medicine that you can give your body. In fact, it’s an investment that you can’t afford not to take up.