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Diabetes Management: Stick to Your Treatment

A lapse could lead to more serious health problems


NIH/National Institute on Aging

Based on content from the NIH/National Institute on Aging AgePage "Diabetes in Older People — A Disease You Can Manage."

Diabetes is a serious disease.

People get diabetes when their blood glucose level, sometimes called blood sugar, is too high.

Diabetes can lead to such dangerous health problems as having a heart attack or stroke.

The good news is that there are things you can do to take control of diabetes and prevent its problems. And if you are worried about getting diabetes, there are things you can do to lower your risk.

What Is Diabetes?

Our bodies change the food we eat into glucose. Insulin helps glucose get into our cells where it can be used to make energy. If you have diabetes, your body may not make enough insulin, may not use insulin in the right way, or both. That may cause too much glucose in the blood. Your family doctor may refer you to a doctor who specializes in taking care of people with diabetes, called an endocrinologist.

Types of Diabetes

There are two kinds of diabetes that can happen at any age. In Type 1 diabetes, the body makes little or no insulin. This type of diabetes develops most often in children and young adults.

In Type 2 diabetes, the body makes insulin, but doesn’t use it the right way. It is the most common kind of diabetes. You may have heard it called adult-onset
diabetes. Your chance of getting Type 2 diabetes is higher if you are overweight, inactive or have a family history of diabetes.

Diabetes can affect many parts of your body. It’s important to keep Type 2 diabetes under control. Over time it can cause problems like heart disease, stroke, kidney disease, blindness, nerve damage, and circulation problems that may lead to amputation. People with Type 2 diabetes have a greater risk for Alzheimer’s disease.

Pre-Diabetes

Many people have “pre-diabetes.” This means their glucose levels are higher than normal but not high enough to be called diabetes. Pre-diabetes is a serious problem because people with pre-diabetes are at high risk for developing Type 2 diabetes. If your doctor says you have pre-diabetes, you may feel upset and worried. But, there are things you can do to prevent or delay actually getting type 2 diabetes. Losing weight may help. Healthy eating and being physically active for at least 30 minutes, five days a week is a small change that can make a big difference. Work with your doctor to set up a plan for good nutrition and exercise. Make sure to ask how often you should have your glucose levels checked.

Symptoms

Some people with Type 2 diabetes may not know they have it. But they may feel tired, hungry or thirsty. They may lose weight without trying, urinate often or have trouble with blurred vision. They may also get skin infections or heal slowly from cuts and bruises. See your doctor right away if you have one or more of these symptoms.

Tests for Diabetes

There are several blood tests doctors can use to help diagnosis of diabetes:

  • Random glucose test — given at any time during the day.
  • Fasting glucose test — taken after you have gone without food for at least eight hours.
  • Oral glucose tolerance test — taken after fasting overnight and then again two hours after having a sugary drink.
  • A1C blood test — shows your glucose level for the past two to three months.

Your doctor may want you to be tested for diabetes twice before making a diagnosis.

Managing Diabetes

Once you’ve been told you have Type 2 diabetes, the doctor may prescribe diabetes medicines to help control blood glucose levels. There are many kinds of medication available. Your doctor will choose the best treatment based on the type of diabetes you have, your everyday routine and other health problems.
In addition, you can keep control of your diabetes by:

  • Tracking your glucose levels. Very high glucose levels or very low glucose levels (called hypoglycemia) can be risky to your health. Talk to your doctor about how to check your glucose levels at home.
  • Making healthy food choices. Learn how different foods affect glucose levels. For weight loss, check out foods that are low in fat and sugar. Let your doctor know if you want help with meal planning.
  • Getting exercise. Daily exercise can help improve glucose levels in older people with diabetes. Ask your doctor to help you plan an exercise program.
  • Keeping track of how you are doing. Talk to your doctor about how well your diabetes care plan is working. Make sure you know how often to check your glucose levels.

Your doctor may want you to see other healthcare providers who can help manage some of the extra problems caused by diabetes. He or she can also give you a schedule for other tests that may be needed. Talk to your doctor about how to stay healthy.

Here are some things to keep in mind:

  • Have yearly eye exams. Finding and treating eye problems early may keep your eyes healthy.
  • Check your kidneys yearly. Diabetes can affect your kidneys. A urine and blood test will show if your kidneys are OK.
  • Get flu shots every year and the pneumonia vaccine. A yearly flu shot will help keep you healthy. If you’re over 65, make sure you have had the pneumonia vaccine. If you were younger than 65 when you had the pneumonia vaccine, you may need another one. Ask your doctor.
  • Check your cholesterol. At least once a year, get a blood test to check your cholesterol and triglyceride levels. High levels may increase your risk for heart problems.
  • Care for your teeth and gums. Your teeth and gums need to be checked twice a year by a dentist to avoid serious problems.
  • Find out your average blood glucose level. At least twice a year, get a blood test called the A1C test. The result will show your average glucose level for the past two to three months.
  • Protect your skin. Keep your skin clean and use skin softeners for dryness. Take care of minor cuts and bruises to prevent infections.
  • 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 foot doctor, called a podiatrist.
  • Watch your blood pressure. Get your blood pressure checked often.

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