Over the last 20 years, the number of adults in the US diagnosed with diabetes has more than doubled. Currently over 34 million Americans, or about 10% of the general population, have the condition, and the vast majority have type 2 diabetes. By 2060, this number is projected to nearly triple due to the rising trend in obesity and aging population.
This means more and more caregivers for elderly parents will need to be well-versed in the progression, symptoms, and treatment options for older adults with this complex disease. Diabetes can have severe repercussions when not treated early or appropriately, including damage to the kidneys, eyes, and heart. As a caregiver, you can have a substantial impact on your elderly parent’s health and longevity by helping to prevent these serious complications.
Diabetes is characterized by a deficiency of a hormone called insulin, which is produced by a large gland called the pancreas. In a healthy person, when blood sugar (glucose) is introduced to the bloodstream from food, the pancreas releases insulin to help transport the glucose into the cells to use for energy. Without enough insulin, too much glucose remains in your bloodstream and can cause organ damage if not addressed.
Type 1 diabetes is an autoimmune disease, meaning the body attacks part of healthy tissue by mistake. When the insulin-producing cells in the pancreas get destroyed, an individual has no way to move glucose into cells. Type 1 diabetes symptoms usually appear suddenly, and the disease is usually diagnosed in childhood or adolescence, although it can develop at any age.
Type 2 diabetes usually develops over many years. When there is consistently too much glucose in your bloodstream (usually as a result of unhealthy eating habits), your pancreas tries to release more and more insulin to compensate. Eventually the body stops responding to the insulin the way it normally would, and we call this becoming insulin “resistant.” Type 2 diabetes typically develops over the age of 45, so it is much more common in the elderly population.
Since symptoms can manifest slowly over time, it’s helpful if caregivers can help identify any changes early on. Symptoms for diabetes can vary widely from person to person, but there is usually a predictable constellation of symptoms when the disease first develops.
The most common symptoms are often called “the three P’s,” and they include: polydipsia (increased thirst); polyuria (increased need to urinate); and polyphagia (increased hunger). Depending on the severity of disease, your elderly parent may experience none or all three.
As diabetes progresses, more serious symptoms may occur. Affected individuals may lose weight without changing eating or exercise routines, experience blurry vision, feel numb in the hands or feet (called diabetic neuropathy, which indicates the possibility of nerve damage), feel fatigued, have sores that heal more slowly than usual, or have an increased number of infections. If you have a parent with diabetes experiencing any of these symptoms, it’s important to contact a provider or diabetes specialist right away for an evaluation.
There are a wide range of treatment options for diabetes. As a caregiver for an elderly parent, it’s important to make sure you understand the prescribed treatment regimen to prevent adverse complications. Diabetes usually does not go away on its own without lifestyle changes and/or medication.
Since diabetes can lead to so many problems if not managed effectively, the primary treatment goal is to prevent severe disease. Newly diagnosed patients may be able to control symptoms with dietary changes and/or exercise alone, but any patient with diabetes will benefit from improving their lifestyle: decreasing sugar intake, increasing fruit and vegetable intake, and increasing the number of daily steps. It may be helpful to discuss these shifts with a nutritionist or diabetes educator to help make sustainable lifestyle adjustments.
There are hundreds of medications on the market to manage diabetes. The most common medication used to manage early stages of the disease is called metformin, which helps keep blood glucose in check. If metformin or other medications are not enough to curb rising glucose levels, your provider may prescribe insulin injections. There are many types of insulin (some act rapidly to lower blood glucose, whereas others work more slowly over a 24-hour period). It’s important to discuss the type of insulin, the patient’s eating habits, the insulin schedule, and the technique with your parent’s provider.
Adjusting to caring for an elderly parent with diabetes can feel overwhelming. It’s important to make sure you have the knowledge and support you need to help your elderly parent manage their treatment plan to prevent caregiver burnout and overwhelm.
Diabetes management often involves complex logistics. Your elderly parent may need to take medication (pills or injections) multiple times per day, and/or complete multiple blood glucose readings per day. Since the care plan can be so involved, consider asking your provider about discussing the care plan with a diabetes specialist to help clarify any questions or concerns. It may be helpful to set reminders for medication dosing or purchase a dedicated pill organizer.
It’s critical to have a self-care regimen as you care for an elderly patient with diabetes. Carefully consider what you are capable of helping with on a routine basis, and ask your provider for tips and tricks about how to simplify treatment regimens. And always make sure you take enough time for yourself!
