Diabetes in the Elderly

In the midst of mentally going through topics I should discuss during our current series on diabetes in our elder population, I received an e-mail from one of my favorite readers. To paraphrase:

“I am concerned about my family member who is in her 70’s and has had diabetes for many years but is not accepting the diagnosis. She only takes her medications sometimes.{{more}} She has been sick with the flu recently so this did not help the situation. She does not follow a proper diet and sometimes sneaks off to eat half a roast breadfruit. She is losing weight and I am not sure where to go from here.”

This e-mail was quite distressing for me to read, partially because I know this reader and her family personally. In fact the family member of concern played a large role in my family throughout many years, so this is close to my heart. But besides that personal factor, her e-mail outlined several issues that come up in people who have had diabetes for a while, especially when they are older. So this week and the next will be devoted to addressing some of the issues raised by this reader in her concern, and what we discussed by e-mail. Hopefully, if you know of a similar situation in your life or someone close, it will shed some light for you.

The first issue about accepting the diagnosis is always hard to overcome. No amount of lecturing or begging by anyone MAKES someone accept a diagnosis within themselves. It truly has to be their own change of mind. I run into this situation all the time mainly in young people who just WILL NOT accept the fact that they have diabetes, a disease that requires them to do WORK on taking care of themselves. But I do run into it in older people as well. There are many reasons why people are hesitant to accept the diagnosis: not wanting to take medication, not facing the fact that your health is not perfect, not wanting to be seen as “sick” etc.

For those of you struggling with family members who will not accept their diagnosis, there are a few things you can do to help them at least live a healthier life while trying to get them to come around:

1) Ask their doctor to make the medication regimen as simple as possible. Maybe taking a pill once a day will make this easier than taking it three times a day. Maybe try combined insulin instead of two separate injections if you can. Sometimes this helps, but know that our options can be limited so don’t go looking for a 7-in-1 pill that takes care of everything. And put the medications where they can see it. You know how it is: out of sight, out of mind.

2) Diabetes-proof the house— If you do the shopping, you essentially control the house. Yes, you are not on the diabetes diet, but it won’t kill you. So change the foods around to make it easier for your family members to do right. Stop buying sodas and juices. Buy fresh fruit and lots of vegetables. Buy whole wheat bread. Make the meat nice and lean, throw out the bacon. Buy the breadfruit but hide it outside….

And just keep encouraging those loved ones. Be persistent but respectful.

More next week. Until then, stay safe ad healthy Vincies!

Anita Ramsetty, MD
endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227