November is American Diabetes Month, and despite decades of promoting awareness, education and fundraising for research, diabetes is a growing problem in the United States. In the last ten years, the number of people of all ages living with diabetes exploded by nearly 50 percent, to over 29 million Americans. Diabetes kills more people every year than AIDS and breast cancer combined – and yet is not the subject of the same kind of public campaigns that those diseases are. Even worse, seniors living with diabetes struggle more to manage the disease than other sufferers, due to factors like medication interactions, higher natural glucose levels, and impaired mobility. But with the right tools and education, caregivers and homecare companions can work with senior diabetes patients to overcome these issues, so that loved ones can live long, healthy lives despite the challenges.
Understanding diabetes begins with knowing how insulin works in the body. Your body turns the food you eat into fuel, in the form of sugars – aka glucose – which is supposed to trigger your pancreas into releasing insulin into the bloodstream. Insulin opens your cells, so the glucose can enter, delivering fuel directly into the cells that need it for energy. But when any of several parts of this process go wrong, you develop diabetes. The most common forms of diabetes are Type 1, Type 2, and gestational diabetes.
Type 1 diabetes is the most severe form, and is also called juvenile diabetes because it usually, though not always, develops in children and teenagers. In this form, in fact an auto-immune disease, the immune system attacks part of the pancreas, identifying insulin-producing cells as foreign cells and destroying them. Without insulin to open the cells to let the glucose in, sugar builds up in the blood, and your cells starve from lack of fuel. Type 1 is considered most severe, because high levels of sugar in the blood can severely damage the eyes, kidneys, nerves, and the heart, and even lead to coma and death. The only way to treat Type 1 diabetes is to inject insulin directly into the blood, but the tricky part is determining how much insulin at what intervals. The food you eat, the exercise you get, your stress level, and your general emotional and physical health all go into calculating the dosage, and both hypoglycemia and hyperglycemia are the risks of getting it wrong.
Type 2 diabetes, on the other hand, typically develops in adults, and is not insulin-dependent. Type 2 diabetes patients produce their own insulin, but not enough, and the insulin they do produce doesn’t perform the ‘cell-opening’ function. So cells don’t receive fuel, and the body experiences insulin resistance. Treatment is easier for Type 2 diabetes, since weight loss, increased exercise, and medication can all help the body use its own insulin more efficiently.
Currently, 29 million Americans suffer from diabetes, and 86 million have what is called pre-diabetes, with nearly 2 million new cases getting diagnosed every year. More than 11 million people over age 65, or 25% of those over 60, have diabetes, and it is a leading cause of kidney failure, blindness, heart failure and stroke – all of which are complications that seniors don’t need. Most disturbing, 25% of people who have the disease already don’t know it, so they are risking terrible complications and receiving no treatment. Maintaining a healthy weight, and exercising regularly to regulate blood sugar levels, are critical components to diabetes treatment. Seniors whose mobility is impaired by other conditions, or whose weight or appetite is increased by medication side effects, can suffer the additional ramifications of glycemic imbalance. Also, aging brings an increased incidence of conditions that cause an increase in blood sugar levels, such as infections, inflammation, and cancer. Certain medications can lead to higher glucose levels, especially steroids like prednisone and cortisone. When they are injected into joints and spinal areas to treat inflammation and arthritis, they can cause a pronounced elevation in blood glucose.
The American Diabetes Association is working toward a future free of diabetes and all its complications for everyone. Education and awareness are the first steps for caregivers and homecare companions whose loved ones are living with diabetes, pre-diabetes, or other conditions that impact blood glucose. Diabetes can be managed, and the team approach is the best way for a loved one to navigate yet another of life’s challenges.
Visit the American Diabetes Association’s website for some fast facts on diabetes.