According to the American Diabetes Association, one out of four Americans who are 60 or older have Type 2 diabetes. Of the 30 million adults in the U.S. who have diabetes, 90-95% of them have Type 2 diabetes. Type 2 diabetes is a condition characterized by high blood glucose levels caused by either a lack of insulin or the body’s inability to use insulin efficiently. Serious complications such as hearing loss, vision problems, cognitive impairment, and mobility difficulties are especially apparent in seniors whose diabetes isn’t properly managed.
The following are some of the most common complications seniors with diabetes face and what can be done to prevent them or slow their progress.
Vision Problems
Prolonged high blood sugar can damage the blood vessels of the retina, causing them to break and leak blood into the eye which can cloud or obscure vision. High blood pressure, which affects about 60 percent of diabetic patients, is another risk factor.
This condition, known as diabetic retinopathy, is a leading cause of blindness in American adults. According to the National Eye Institute, between 40-45 percent of Americans diagnosed with diabetes have some stage of diabetic retinopathy.
Symptoms of diabetic retinopathy include:
- Blurred or double vision
- Flashing lights, which can indicate a retinal detachment
- A veil, cloud, or streaks of red in the field of vision, or dark or floating spots in one or both eyes, which can indicate bleeding
- Blind or blank spots in the field of vison
If you have diabetic retinopathy, your doctor can recommend treatment to help prevent its progression. If caught early enough, it may be treatable with laser surgery that seals leaky blood vessels and discourages new leaks from forming. The surgery is not a cure-all, however, as retinopathy can reoccur, especially if you don’t control your blood sugar levels.
Since it can take years for high blood sugar to trigger diabetic retinopathy, having regular eye exams are important, as they can detect signs of the condition before symptoms surface.
Hearing Loss
The National Institute of Health has concluded that hearing loss is twice as prevalent among older adults with diabetes. In the estimated 79 million adults with pre-diabetes, the rate of hearing loss is 30 percent higher than in those with normal blood glucose.
High glucose levels over time can damage small blood vessels and nerves inside the ear. Older adults account for the majority of the patients with diabetes-related hearing loss, but anyone who doesn’t control their diabetes or who has had the disease for a long time is at risk.
Signs of hearing loss include:
- Frequently asking others to repeat themselves
- Trouble following conversations that involve more than two people
- Thinking that others are mumbling
- Problems hearing in noisy places such as busy restaurants
- Trouble hearing the voices of women and small children
- Turning up the TV or radio volume too loud for others who are nearby
If you suspect a hearing loss, be sure to tell your doctor and get a full hearing exam. Hearing loss is typically irreversible, but it may be managed with the use of a hearing aid.
Cognitive Impairment
According to a 2013 study published in the New England Journal of Medicine, higher blood sugar levels may have “deleterious effects on the aging of the brain” and increase a person’s risk for dementia.
A December 2014 study by Johns Hopkins Bloomberg School of Public Health found that people diagnosed with diabetes in midlife are more likely to experience significant memory and cognitive problems during the next 20 years than those with healthy blood sugar levels.
“The lesson is that to have a healthy brain when you’re 70, you need to eat right and exercise when you’re 50,” says study leader Elizabeth Selvin, PhD, MPH, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health. “There is a substantial cognitive decline associated with diabetes, pre-diabetes and poor glucose control in people with diabetes. And we know how to prevent or delay the diabetes associated with this decline.”
Screening older diabetic patients for cognitive impairment, regardless of the underlying cause, is critical because it can interfere with their ability to manage the disease. Recording blood sugar levels, managing diet, and taking medication on time can become an issue, as well as coordinating doctor’s appointments. Caregivers can help ensure that older adults are properly managing their disease.
Mobility Difficulties
Arthritis and other bone or joint issues can make getting around difficult for many older adults, but diabetes can exacerbate the problem if a patient develops neuropathy, or nerve damage, in their feet. According to the Mayo Clinic, at least half of all people with diabetes develop neuropathy.
The symptoms of neuropathy are wide-ranging and depend entirely on the form of neuropathy present, and which nerves are being affected. People with neuropathy typically feel numbness or a reduced ability to feel pain in their feet and toes, as well as tingling or burning sensations and pain that increases while walking or sleeping. These sensations can interfere with routine activities, including dressing and basic mobility.
As a result of decreased sensitivity from diabetic neuropathy, many people with diabetes don’t notice when they develop foot ulcers. “If a person doesn’t have full sensation in the bottom of the feet, sometimes they’ll develop wounds from stepping on something or getting something in their shoe, and they don’t feel it, and then it will take months and months to heal,” said Yael Reich, a diabetes clinical specialist with Partners in Care.
Remaining active is important because exercise can reduce the pain while helping lower blood sugar levels. Reich also recommends checking your feet daily to spot and treat wounds or ulcers as soon as possible. Untreated wounds can become infected and lead to gangrene, or tissue death, and amputation.
“We are able to decrease the likelihood of terrible complications that can cause blindness, loss of limbs and more by controlling glucose and A1C level,” said Betul Hatipoglu, MD, and endocrinologist at the Cleveland Clinic. Doctors are paying attention to these things, but the patients and even caregivers need to know as well to prevent these things from happening.”
If you have already been diagnosed with diabetes, the following American Diabetes Association guide, Living Healthy with Diabetes, may help.
If you are a caregiver of a loved one with Type 2 diabetes, check out some of these useful tips on caring for an older adult with diabetes from Care.com.
Contact Lifeline Homecare to find out more about how we can help provide non-medical homecare for loved ones with Type 2 diabetes: care@lifelinehomecare.org