As the term “Type 1 diabetes” gradually replaces “juvenile diabetes,” the change recognizes an important truth: Once you’ve been diagnosed, you will have Type 1 diabetes for life, not just until you’re able to drink alcohol and to vote.
Because Type 1 is most often diagnosed in childhood, however, it is disproportionately linked to the juvenile years. By the time we turn 21, most Type 1s are adept at managing glucose levels and administering insulin, and so, in adulthood, diabetes no longer seems a crisis, just a condition. This is a good thing, unless we grow too complacent as we age.
The fact is, being elderly and having diabetes are states that, until recently, did not co-exist.
For many of our ancestors, a malfunctioning pancreas was a death sentence. It wasn’t until the advances of the early 20th century – the discovery of insulin and the development of synthetic versions – that we were able to aggressively spar with, and eventually conquer, this foe. Although people with diabetes can still be vulnerable to serious complications, more and more of us are happily living to be “geezers” by developing, and adhering to, plans for our medical care.
Along with the pleasures of old age also come challenges, which can sometimes include memory loss. For people without diabetes, forgetfulness isn’t usually life threatening; but for people with diabetes, it can be. It’s important, therefore, for people with Type 1 to have a strong support system of people who can note if our memory is slipping, and if necessary, to help us to make necessary accommodations in our treatment plans.
The International Diabetes Federation has compiled guidelines for the care of older people with diabetes. It’s long (96 pages) and directed primarily for caregivers, but worth a look when considering strategies for your own care. But managing diabetes in the elderly goes beyond cognitive abilities; it also must include basic self-care that is important for anyone, but especially critical for people who live with diabetes.
Exercise, for example, is vitally important in every T1 treatment plan, however, as people age, they tend to become more sedentary. People with diabetes, therefore, must make exercise a habit, a life ritual on par with showering or brushing their teeth. The more ingrained an exercise routine becomes earlier in life, the easier it will be to maintain it in old age.
Foot care, too, becomes more important as people with diabetes age. Those of us with Type 1 are more susceptible to infection than the general population, and something as benign as an ingrown toenail, left untreated, can morph into an infection. Again, good habits developed in early adulthood are likely to endure into old age.
The intake of food and drink is also a concern that increases with years. Our appetites tend to decline in old age, which may be good for the budget, but bad for our blood glucose levels. The threat of hypoglycemia and hyperglycemia, therefore, increases as our appetites wane. Since mental fuzziness and confusion is a symptom of hypoglycemia, our condition can quickly go from bad to worse, another reason why elderly diabetes management requires a strong support system.
Finally, the elderly benefit greatly from new technology that helps remind them to check their glucose levels, or to administer a shot. (Such as our insulin pen cap.) Everyone can use a little reminder now and then, regardless of age, and there’s no shame in employing extra resources when managing a challenging condition. Then you’ll be free to enjoy the assorted liberties of old age.