According to the American Diabetes Association (ADA), diabetes is a leading cause of death in the United States for people over 75. About 20 percent of the people ages 65 to 74 in the United States have diabetes. People with diabetes are 2 to 4 times more likely to die from cardiovascular disease than those without diabetes. Type 2 diabetes, which used to be called adult onset is a condition that causes the body to have trouble processing complex carbohydrates and sugars. A major function of the pancreas is to make additional insulin to use the sugar (or glucose) that is produced from food. When the unused glucose — sugar — starts to build up, trouble begins. According to the National Kidney Foundation, between 10-40 percent of individuals with Type 2 diabetes will suffer from kidney failure. Chronic kidney diseases and renal disorders are conditions that damage the kidneys making them less able or unable to perform their normal function of eliminating waste. Chronic kidney diseases may be caused by diabetes or high blood pressure and can lead to weak bones, poor nutritional health, or heart and blood vessel disease. If kidney disease progresses, it can lead to kidney failure, requiring dialysis or a transplant.
Besides leading to coronary artery disease and stroke, diabetes can also cause diseases of the blood vessels leading to the extremities—especially the feet. Amputations are a reality of this progressive disease as it affects the circulatory system.
About 60 percent to 70 percent of people with diabetes have mild to severe forms of nervous system damage.
More than 60 percent of non-traumatic lower-limb amputations occur in people with diabetes.
According to the American Optometric Association, “about 50 percent of adult blindness is due to diabetes.” People with diabetes are 40 percent more likely to develop glaucoma. Similarly, 60 percent are more likely to develop cataracts .”
But the good news is that Type 2 diabetes (unlike Type 1, which most often affects patients in childhood) is 90-95 percent preventable. Making changes in diet and increasing physical activity may allow blood glucose levels to return to the normal range. Some medications may delay the development of diabetes, but diet and exercise are the best remedies.
- Age 65 and over
- High blood pressure Impaired glucose tolerance
- Irregular exercise
- Low HDL cholesterol and high triglycerides
- African-American, Hispanic, Asian, Pacific Islander and Native Americans
- Women who had gestational diabetes or who have had a baby weighing 9 pounds
or more at birth
The American Diabetes Association’s CheckUp America! program recommends:
- Maintaining optimal weight (losing 5-10 percent of your body weight is very beneficial)
- Doing aerobic exercises for 30 minutes per day five times per week
- Doing strengthening exercises several times a week such as weights, elastic bands, or plastic tubes
- Doing stretching exercises 5-10 minutes before doing aerobic exercises
- Being active during the day (i e taking the stairs, working in the garden, cleaning the house).
- Stopping smoking
- Controlling glucose, cholesterol and high blood pressure
- Eating healthy by following the United States Department of Agriculture nutrition guidelines, shopping smart for food, and eating healthy snacks.
The Diabetes Risk Test is an ADA interactive computerized tool that measures risk based on ethnicity, age, weight, height, family history, high blood pressure, physical activity, body mass index, and history of diabetes during pregnancy. Based on these criteria, the Risk Test makes recommendations for life style changes.
Diagnosing diabetes involves a fasting blood glucose (FPG) test Individuals who have a FPG of less than 100 are healthy. Those with an FPG between 100-125 are considered pre-diabetic; while those with an FPG over 125 are diabetic.
Symptoms may include fatigue or nausea, frequent urination, unusual thirst, weight loss, blurred vision, frequent infections or slow healing of wounds or sores.
Treatment & Management
Engage in a physical activity for 30 minutes or more most days of the week that includes walking, taking the stairs, or moving around— throughout the day; aerobic exercise, such as brisk walking, swimming, or dancing; strength training, like lifting light weights; and flexibility exercises, such as stretching.
Keep a record of weight, as well as daily food intake, liquids consumed, and physical activity. Have a healthy blood pressure (ideal 120/80; early high blood pressure between 120/80 and 140/90; high blood pressure 140/90 or higher). Take medications per the medical provider’s instructions. Check blood glucose levels per the medical provider’s instructions.
With a physician’s referral for diabetics, Medicare will pay for diabetes self-management training, medical nutrition therapy, diabetic supplies, including blood sugar monitors, lancets, and test strips, insulin and supplies to inject it (covered under Medicare Part D), special eye exams, hemoglobin A1c tests (a blood test to see how well your blood sugar has been controlled for the past three months), insulin pumps (co-pay may be applicable), special foot care (co-pay may be applicable) and therapeutic shoes (co-pay may be applicable).
Here are some ideas for improving your diet:
- Plan a daily diet consisting of fruits and non-starchy vegetables such as spinach, carrots broccoli, or green beans with meals.
- Choose whole grain foods over processed products. Include dried beans and lentils in your meals.
- Eat fish 2-3 times a week.
- Choose lean meats like cuts of beef and pork that end in “loin” such as pork loin and sirloin.
- Remove skin from chicken and turkey.
- Choose non-fat dairy such as skim milk, non-fat yogurt and nonfat cheese.
- Choose water and calorie-free “diet” drinks instead of regular soda, fruit punch, sweet tea and other sugar-sweetened drinks.
- Choose liquid oils such as olive and canola oils for cooking instead of solid fats that can be high in saturated and trans fats. Remember: fats are high in calories.
- Cut back on high-calorie snack foods and desserts like chips, cookies, cakes and ice cream.
- Eat breakfast every day.
- Eat five small meals every day to balance energy and metabolism.
- Eating too much of even healthy foods can lead to weight gain. Watch your portion sizes.
- Know carbohydrates and avoid foods made with white flour.
Questions for Your Doctor
- How often should I check my feet and what should I be checking? When shall I call a health care provider?
- What do I need to know about my blood sugar levels and how do I adjust my medications?
- How do I take my medications and what changes do I make if I am sick?
- Am I at risk for kidney failure?
- Do I need to see an ophthalmologist?
- Are there community resources for diabetic education, renal failure classes and/or vision care?
The American Diabetes Association recommends:
- Control portion sizes by dividing your plate in half; fill one half with vegetables, fill one fourth with starches and carbohydrates and one fourth with protein.
- About half of all men who have diabetes suffer from erectile dysfunction. Although stress and other factors can interfere with a healthy sex life, diabetes interferes with physical reactions that lead to erections.
- If your health is at risk and you are ready, willing, and able to change your behaviors, follow the “Small Steps Program” sponsored by the ADA.
- The American Optometric Association recommends having an annual dilated eye exam to help with the diagnosis and treatment of diabetes, as well as the management of pre-diabetic conditions.
American Diabetes Association or call 1-800-342-2383
American Optometric Association or call 1-800-365-2219
National Kidney Foundation or call 1-800-622-9010
Medical Education Institute