Written by Carol Marak, founder of the Elder Orphan Facebook Group
Solo seniors deal with many critical issues. And adding a chronic illness in the mix, like diabetes, will turn up the knob on worry, the need for information, and support. The Centers for Disease Control (CDC) says diabetes is a prolonged illness that affects how your body turns food into energy.
Food metabolizes into sugar or glucose and releases into the bloodstream when eaten. When blood sugar spikes, it signals the pancreas to release insulin, which acts like a doorway to let the blood sugar into the cells to use for energy.
With diabetes, a person either doesn’t make enough insulin or can’t efficiently utilize the insulin it makes. So the cells stop responding to insulin, keeping sugar in the bloodstream. Over time, that can cause heart disease, vision loss, and kidney disease, even death.
The best ways to manage the disease on your own are to keep health care appointments, keep blood sugar in check, maintain a healthy weight, eat nutritious foods, and stay physically active through exercise. In some cases, medications are needed, and taking them as needed reduces the impact of diabetes.
Almost 30 million Americans have diabetes and 80 million are prediabetic. While 8.1 million Americans have undiagnosed diabetes. It’s important to get your blood sugar checked by a doctor.
Get a glucose screening
The American Diabetes Association recommends blood glucose screening:
At age 45 or older
If overweight at any age, with one or more additional risk factor, such as a family history of diabetes, a personal history of prediabetes or an inactive lifestyle
After age 45, your doctor will likely recommend screening every three years.
Share your concerns about diabetes prevention with your doctor. He or she will appreciate your efforts to prevent diabetes and may offer additional suggestions based on your medical history or other factors.
Take the 60 second diabetes risk test sponsored by the American Diabetes Association
Be sure to schedule regular check-ups with your doctor and take healthy steps toward preventing or delaying diabetes.
Types of diabetes
Questions to Ask Your Doctor about Diabetes
Use these questions when speaking with your healthcare team:
Should I check my blood sugar levels at home with a glucose monitor? How often should I check them?
Know the Sugar Addiction Facts
What are my goals regarding blood sugar levels?
What are the blood sugar (glucose) targets for diabetes?
What are the warning signs or symptoms that my blood sugars are too high? What do I do if my blood sugars are too high?
What are the warning signs or symptoms that my blood sugars are too low? What do I do if my blood sugars are too low?
How can I change my lifestyle and diet in a way that will be healthy?
Other questions to ask your physician, plus a few resources:
Will I always need medications/insulin? How will you evaluate whether these medications are the best treatment for me?
What are the long-term complications of diabetes, and how can I avoid them?
How do other factors such as high cholesterol and high blood pressure affect me if I have diabetes?
How often should I be seeing my doctor to optimize my diabetes management?
How to Stay Safe When Living Alone with Diabetes
The top concern for people who live alone with diabetes and take insulin or medications that can cause low blood glucose is hypoglycemia. If you live alone, it can be a real danger if you should have a hypoglycemic episode. The biggest concern is ensuring that you're safe and know what to do to treat low blood sugar and how to prevent it from happening.
Top Tips
Learn the symptoms of hypoglycemia. Understand not every person living with the disease experience getting shaky, sweaty, and confused. You could have a condition called hypoglycemia unawareness. Or maybe you take beta-blockers that dull or eliminate warning symptoms.
Create a strategy in case your blood sugar goes low. Have a closeby treatment option—a fast-acting source of glucose to use such as glucose tablets, gels, and juice boxes. Keep them in your car, nightstand, on the coffee table. Stay where you are and treat. Otherwise, you are at high risk of falling.
Have emergency contact and health Information nearby. Make a list of emergency contacts--friends, family, endocrinologist, and pharmacy. Keep the list in an easily accessible place. Have medical records handy. Strongly consider wearing a medical alert ID, which lists important medical information, such as emergency contacts and diabetes.
Keep a close watch on your glucose--check it regularly. This is your thermostat. If there’s a change in activity, weight, or stress--you need to keep a watchful eye on sugar levels because these changes affect your glucose. Track them and share with your doctor. There might be a trend that the doctor can spot.
Use continuous glucose monitors which alert you whether blood glucose is rising or falling. Look for newer continuous glucose monitors that can send alerts to another person's smartphone. Medicare currently doesn't cover the devices for any enrollees.
Exercise with caution and be smart. Physical activity can lower blood glucose, you shouldn't be afraid to exercise, just be aware and check the glucose level before and after the activity. Always bring the glucose back-up kit. Other activities could lead to hypoglycemia: yard work, long walks while shopping, vacation strolls, etc. Check blood glucose regularly, and eat carbs as needed.
After the workout, be prepared for a delayed reaction. You might experience a drop in six hours later, so keep track of how you feel for up to 24 hours after exercising. This strategy helps you spot a trend.
Use the Snug Safety app: Adopt a buddy system. Reach out to family, friends, and neighbors, and make sure you have someone who is checking in on you—with in-person visits, and daily phone calls. When setting up your contacts in the check-in app, let your emergency contact know you have diabetes. So, if you fail to check-in for the day, the emergency contact is one high alert. Make sure that your emergency contact or another person checking in on you is trained to dose you with glucagon—an injected hormone that comes in a kit—if you can't treat hypoglycemia due to severe confusion or unconsciousness.
Know Your Goal Range. Know your blood glucose goal range and let your physician know if you’re having bouts of low blood glucose. This may be a sign your meds need adjusting. In addition to medication changes, having a bedtime snack like Glucerna or Extend bars. These can help with overnight hypoglycemia. Be sure to discuss with your doctor.
Learn about glucose monitoring and tracking
The Need for Social Support
An expanded social support system includes friends, neighbors, and other relationships including family. Having a strong one when in need or during an emergency helps lower stress and worry, and provides a buffer against adverse situations. It’s a critical need for adults aging at home alone.
Types of social support:
Emotional support pertains to the feelings of being cared about and cared for by others.
Instrumental support has to do with the physical activities such as paying bills, handling finances, and maintaining the house.
Informational support means having access to needed information and education.
Support groups provide psychological support.
Grow Your Social Network
The University of Minnesota suggests social support and networks give a sense of belonging, security, and a community where you can share your concerns and needs and support others. There are simple ways to connect and maintain social connections by having a cup of coffee or taking a walk with a friend, going on an outing with a church or social club.
Building a community of support increases confidence, purpose, and self-worth, and can help one deal with illness, death, and depression. Even if you just occasionally get together, just knowing they’re available can reduce the negative responses to events and challenges.
Here are ways to connect with other people:
Work out
Take a walk with your pet
Volunteer
Find others who share a hobby
Join a cause
Read the Snug Develop Your Support Guide for more ways to create and build healthy social ties.
Remember support is a two-way street. Sometimes you give it and other times you receive it. When forming close associations, make sure they’re with reliable and trustworthy people.
Letting people know you love and appreciate them will increase the bonds.
Find Support and Community
Maybe you or a loved one has type 1, type 2, or prediabetes. Regardless, the American Diabetes Association online community is the place for you to listen, learn, ask questions, and share your story with others who are going through the same thing.
How support helps individuals with diabetes:
Your never feel you’re alone and isolated
You’ll receive practical advice and tips
You’ll be encouraged to take good care of you
You will have access to the latest research and experts
Join ADA (American Diabetes Association) Education Series
Join ADA’s monthly Q&A with diabetes experts—online or on the phone. Learn the connection between diabetes and heart health. Get answers to your questions.
The Ask the Experts series is designed to help tackle issues commonly faced by people living with diabetes and want to understand the link between diabetes, heart attacks, stroke, and heart failure.
Ask the Experts
Tips to Take Better Care of Yourself in Social Activities & Events
Get involved in the menu planning
Let people know you must eat regularly, when out with friends and family
Educate your friends about low blood sugar symptoms
Make plans in the earlier evening
If you slip up, don’t beat yourself up
Diabetes Type 1 and Type 2
Type 1
An estimated 5 percent of the people who have diabetes have type 1. Symptoms develop quickly and usually diagnosed in children, teens, and young adults. If you have type 1 diabetes, you’ll need to take insulin every day to survive.
Different factors, including genetics and some viruses, may contribute to type 1 diabetes. Although type 1 diabetes usually appears during childhood or adolescence, it can develop in adults.
There’s no preventative measures for type 1.
Symptoms
Type 1 diabetes signs and symptoms can appear relatively suddenly and may include:
Increased thirst
Frequent urination
Bed-wetting in children who previously didn't wet the bed during the night
Extreme hunger
Unintended weight loss
Irritability and other mood changes
Fatigue and weakness
Blurred vision
Complications
Over time, type 1 diabetes complications can affect major organs in your body. Maintaining a normal blood sugar level can dramatically reduce the risk of many complications.
Heart and blood vessel disease. Diabetes dramatically increases your risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke, narrowing of the arteries (atherosclerosis) and high blood pressure.
Nerve damage -- Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in the legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.
Kidney damage -- The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease.
Eye damage -- Diabetes can damage the blood vessels of the retina, potentially causing blindness. The risk of other vision conditions are cataracts and glaucoma.
Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of foot complications. If left untreated, cuts and blisters can turn into serious infections that could require amputation.
Skin and mouth conditions. Diabetes may leave you more susceptible to infections of the skin and mouth.
Prevention
There's no known way to prevent type 1 diabetes. But researchers are working on preventing the disease or further destruction it causes.
Check with your doctor to see if you are eligible for a clinical trial. As with any experiment, carefully weigh the risks and benefits of the treatment.
Type 2
Of the 30 million Americans living with diabetes, 90 to 95 percent of those have type 2. Type 2 develops in people over age 45, but more and more children, teens, and young adults are also developing it. Type 2 diabetes used to be known as adult-onset diabetes, but today more children are being diagnosed with the disorder, probably due to the rise in childhood obesity. There's no cure for type 2 diabetes, but losing weight, eating well and exercising can help manage the disease. If diet and exercise aren't enough to manage your blood sugar well, you may also need diabetes medications or insulin therapy.
Risk factors
Factors that may increase your risk of type 2 diabetes include:
Weight. Being overweight is a main risk factor for type 2 diabetes.
Fat distribution. If you store fat mainly in the abdomen, you have a greater risk of type 2 diabetes and if you’re a man with a waist circumference above 40 inches or a woman with a waist that's greater than 35 inches, the risk increases.
Inactivity. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin.
Family history. The risk of type 2 diabetes increases if your parent or sibling has it.
Race. It’s unclear why but African Americans, Hispanics, American Indians and Asian-Americans are more likely to develop type 2 diabetes than white people are.
Prediabetes left untreated can progress into type 2 diabetes.
For women, having polycystic ovarian syndrome — a condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes.
Areas of darkened skin, usually in the armpits and neck often indicates insulin resistance.
Complications
Type 2 diabetes can be easy to ignore, especially in the early stages when you're feeling fine. But diabetes affects many major organs, including your heart, blood vessels, nerves, eyes and kidneys. Controlling your blood sugar levels can help prevent these complications.
Although long-term complications of diabetes develop gradually, they can eventually be disabling or even life-threatening. Some of the potential complications of diabetes are very similar to type 1.
Prevention
Healthy lifestyle choices can help prevent type 2 diabetes. Use healthy lifestyle choices to help prevent complications. If you have prediabetes, lifestyle changes can slow or stop the progression.
A healthy lifestyle includes:
Nutritious and healthy foods. Choose foods lower in fat and calories and higher in fiber. Eat mostly fruits, vegetables and whole grains.
Get active. Aim for 30 to 60 minutes of moderate physical activity — or 15 to 30 minutes of vigorous aerobic activity, on most days. If you can't fit in a long workout, spread your activity throughout the day.
Lose weight. If you're overweight, losing 5 to 10 percent of your body weight reduces risk.
Avoiding being sedentary for long periods. Get up every 30 minutes and move around for at least a few minutes.
Signs and symptoms of type 2 diabetes develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for:
Increased thirst
Frequent urination
Increased hunger
Unintended weight loss
Fatigue
Blurred vision
Slow-healing sores
Frequent infections
Areas of darkened skin, usually in the armpits and neck
Source: Disease Conditions
Other Steps to Follow
Check your blood sugar levels; know your A1C
Check your blood pressure, cholesterol, eyes, feet and teeth
Know your pills and insulins, understand how they work and take the right doses at the right times
Recognize your high and low blood sugars, understand what caused them and learn to treat and prevent them
Quit smoking
Do regular health exams (eye, foot, dental)
See your doctor regularly for check-ups and tests
Get support from your family, friends and diabetes care team
Set realistic goals and work toward them
Source: Health Insights
Additional Diabetes Resources and Management
Center for Disease Control (CDC)
Diabetes Educator
More Support Groups
Where to Find More Diabetes Resources and support groups
To best care for yourself or another person living with diabetes, be sure to follow the doctor’s orders, track your glucose levels, stay on top of blood tests and results, eat healthy foods, find support, stay active and become educated on the latest expert advice, news and trends.
