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Type 2 Diabetes and the Elderly

Type 2 diabetes, which is often called adult-onset diabetes because adults account for nearly 95 percent of all diagnosed cases, is a chronic disease in which high insulin resistance leads to high levels of glucose (sugar) in the blood.

The National Diabetes Information Clearinghouse reports that this disease is the leading cause of kidney failure, blindness, and lower-limb amputations in the United States. It is also a major cause of stroke and heart disease and is the seventh leading cause of death in the United States.

Type 2 diabetes, according to the American Diabetes Association, is the most common form of diabetes, affecting about 25.8 million people in the United States, or about 8.3 percent of the population. The American Diabetes Association also estimates that there are nearly 7 million people in the United States that are undiagnosed with type 2 diabetes.

In 2010, 10.9 million residents 65 and older were living with Type 2 diabetes.

Causes of Type 2 Diabetes

Diabetes occurs when the body fails to make or properly utilize insulin. In particular, an individual’s fat, liver and muscle cells fail to adequately respond to insulin, which leads to a lack of blood sugar in these cells but a buildup of sugar in the blood. In other words, when sugar cannot enter the cells of the body, it instead builds up in the blood stream, leading to hyperglycemia and, eventually, Type 2 diabetes.

Type 2 diabetes is associated with advanced age, obesity, physical inactivity, race/ethnicity, and a family history of diabetes. African Americans, Native Hawaiians, Asian Americans, Hispanic Americans, and American Indians are all at a higher risk for developing Type 2 diabetes.

The majority of people with diagnosed Type 2 diabetes are overweight, as more fat makes it more difficult for a body to properly process insulin. However, among the elderly, even thin people may develop Type 2 diabetes.

Although a small percentage of Type 2 diabetes is present in children and adolescents, the vast majority occur in adults.

Signs and Symptoms of Type 2 Diabetes

The vast majority of people with Type 2 diabetes have no signs or symptoms of the disease for many years. However, some of the first signs to appear include:

  • Fatigue (feeling tired all the time)
  • Hunger (a sharp increase in appetite)
  • Increased thirst (unquenchable thirst)
  • Increased urination (a marked increase of bathroom visits)

Further, other first signs of Type 2 diabetes may include blurred vision, pain or numbness in the hands or feet, and erectile dysfunction in men.

Diagnosis of Type 2 Diabetes

Type 2 diabetes is diagnosed by measuring a patient’s blood sugar level. This can be done in one of three ways:

  • Fasting blood glucose test
  • Hemoglobin A1c test
  • Oral glucose tolerance test

However, many doctors recommend screening tests to their patients if they meet a number of risk factors. In particular, overweight adults with a BMI greater than 25 and adults over the age of 45 are often urged to get screening tests at least every 2 to 3 years.

Treatment of Type 2 Diabetes

Type 2 diabetes is treated through dietary changes, exercise, and medication, although patients who don’t respond to medication and dietary and lifestyle changes may also need to receive insulin.

Lifestyle Changes
Individuals with diagnosed Type 2 diabetes must learn how to test and record their blood glucose levels; how to properly take their medication; how to recognize and treat fluctuations in blood sugar levels; and how to store diabetes supplies.

The treatment of Type 2 diabetes begins with managing blood sugar levels, which means at-home self-testing with a glucometer. Keeping blood sugars at an optimum level may mean making significant changes to an individual’s diet. Many Type 2 diabetes patients work with nutritionists to create and follow balanced diets and to achieve a healthy weight. Weight loss is often the primary goal of those diagnosed with Type 2 diabetes.

Further, it is recommended that individuals with Type 2 diabetes increase their activity level, as exercise has been shown to have a dramatic effect on controlling blood sugar levels, maintaining a healthy blood pressure, and achieving a healthy weight.

Medication
If diet and exercise alone does not control blood sugar levels, Type 2 diabetes patients may need to take medication for lowering blood sugar levels. Because different diabetes medications work to control blood sugar levels in different ways, it is common for Type 2 diabetes patients to require more than one type of medication.

Some of the most common types of Type 2 diabetes medications include:

  • Sulfonylureas
  • Injectable medications (such as exenatide, pramlintide, sitagliptin, and saxagliptin)
  • Alpha-glucosidase inhibitors
  • Biguanides
  • Meglitinides
  • Thiasolidinediones

Insulin
If blood sugar levels cannot be controlled through a combination of medication and lifestyle changes, insulin injections may need to be started. Insulin injections are not a substitute for a healthy lifestyle, diet, exercise program, and medication, and insulin is often used in additional to oral medications.

Prevention of Type 2 Diabetes

Type 2 diabetes may lead to a number of serious and life-threatening medical conditions, making the prevention and treatment of this disease so crucial. Just some of the risks associated with Type 2 diabetes include: heart attack; stroke; eye disease and blindness; kidney disease; high blood pressure; high cholesterol; skin problems (sores and infections); foot problems; slow-healing infections; and nerve damage.

Often, the best way to prevent developing Type 2 diabetes is to maintain a healthy weight, follow a healthy diet, and get regular exercise.

Resources for Type 2 Diabetes

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