Aging Well: Education, positive attitude are keys to diabetes management

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November is American Diabetes Month. Many resources are available to help people with diabetes and their caregivers/family members:

• Diabetes Education Programs offer counseling, resources and support groups for people with diabetes. For more information, call Jane Dickinson at Yampa Valley Medical Center in Steamboat Springs, 871-2352; or Amy Knights at The Memorial Hospital in Craig, 826-2511.

• Healthier Living Colorado is a free workshop designed to help older adults self-manage diabetes and other chronic conditions. For information about upcoming classes in Routt and Moffat counties, call 871-7676.

• Additional resources include The American Diabetes Association,

www.diabetes.org; the National Diabetes Education Program, www.ndep.nih.gov; and the National Diabetes Information Clearinghouse, www.diabetes.nidd...>

Editor’s Note: This article was originally published Nov. 17, 2008. It has been updated for accuracy.

Saundra Steele first noticed her vision problems on a routine drive to Craig. Road signs, which normally appeared clear, were blurry, even through her prescription glasses.

A trip to the doctor confirmed her suspicion: She had Type 2 diabetes, a condition she had likely inherited from her father, who also had been diagnosed with the disease in his 60s.

With a good understanding of diabetes and a background in nutrition, Steele, now 72, felt reasonably prepared to tackle the life changes and routines that would keep her healthy. That doesn’t mean it was easy. Experimenting with different foods and recipes, exercising more and waiting for the right results often proved frustrating.

Information from diabetes education programs, support groups, cookbooks and magazines for people with diabetes has been a powerful tool in helping Steele tackle these challenges while keeping her head up in the process.

“It’s pretty overwhelming, but it’s not something you can’t overcome,” she said. “You just have to give it time and make sure you have support.”

The Memorial Hospital in Craig and Yampa Valley Medical Center in Steamboat Springs have diabetes education programs to help individuals learning to live with diabetes.

Steele stressed that all individuals with the condition take advantage of what these programs have to offer.

“It’s very important people get on the right track,” she said.

Diabetes and adults

More than 20 percent of adults 60 and older have diabetes — more than double the percentage of younger adults that have the condition, according to the U.S. Centers for Disease Control and Prevention.

Diabetes is a condition in which the body does not make any or enough of the hormone insulin and/or does not effectively use insulin to change glucose derived from sugars, starches and other food, into energy. This results in blood glucose levels or blood sugar to be too high.

Type 2 diabetes, in which the body makes insulin but does not use it the right way, makes up the vast majority of new diabetes cases every year.

Jane Dickinson, diabetes education program director at Yampa Valley Medical Center, notes that the high occurrence of diabetes in older adults may be due in part to the sheer numbers of aging baby boomers. However, older adults also are more susceptible to a non-preventable form of Type 2 diabetes brought on by age-related changes in the body. At the same time, inactivity, excess body weight — particularly in the area of the abdomen — and/or family history, are more prevalent causes of Type 2 diabetes than age, she said.

People can live with slightly elevated glucose levels for many years. Though sometimes mild or gradual, signs such as blurry vision, fatigue, hunger, thirst, weight loss, frequent urination and slow healing cuts or bruises, are signs of the disease. Throughout time, diabetes can damage the heart, blood vessels, eyes, kidneys, nerves, teeth and gums.

Many people with type 2 diabetes end up being diagnosed during a routine physical exam, community health fair blood draw or, worse, after a heart attack, stroke or infected cut, Dickinson said.

It’s important that all adults understand the risk factors and symptoms of diabetes so, like Steele, they can begin managing their condition to prevent or delay complications.

Individuals with pre-diabetes or higher than normal blood-glucose levels that aren’t quite high enough to be considered diabetes, can actually prevent the onset of Type 2 diabetes with healthy lifestyle changes.

Education and support

There are many resources to help individuals overcome the initial shock of diagnosis and not just maintain, but actually improve, their quality of life despite having diabetes.

One of the first steps is diabetes education, a service that is widely available to people with diabetes and included in Medicare benefits.

Diabetes education programs, along with doctors, provide people with diabetes information and ongoing support to help them monitor their conditions and learn to balance their blood glucose levels with a combination of a healthy diet, exercise and possibly diabetes medication.

Counselors also make people with diabetes aware of potential short- and long-term complications or problems related to the disease.

Older adults, for example, may be at higher risk for falls if they take diabetes medications that can cause low blood glucose levels which, in turn, may impair concentration and reflexes, Dickinson said.

Older people with diabetes also are encouraged to check their feet daily for problems and get regular blood pressure checks, routine eye and foot exams, tests for kidney function and A1C tests, which test a person’s average blood glucose level for the past two to three months.

“Diabetes education is the cornerstone of diabetes management,” Dickinson said. “Being informed is, above all else, the foundation of taking care of yourself.”

Individuals with diabetes also may visit with a dietitian to develop a personalized meal plan that will help balance their blood sugar levels and/or lose excess weight that prevents insulin from working efficiently.

Moderate exercise is an important part of diabetes management because it not only helps individuals lose weight or maintain a healthy weight, it also can improve a person’s attitude and ward off depression.

A Diabetes Prevention Program study published in 2002 found that individuals 60 and older with pre-diabetes who exercised regularly and ate foods low in fat and calories reduced their risk of developing Type 2 diabetes by 71 percent.

The regular exercise — walking 30 minutes five days a week — helped participants lose 5 to 7 percent of their body weight.

“For a lot of people that’s doable,” Dickinson said.

Having a good support system that includes informed family members, caregivers and friends as well as support from other people with diabetes is critical in helping ease the diabetes management process, Dickinson said.

Family members and caregivers are encouraged to attend at least initial diabetes counseling with their loved ones who have diabetes. People with diabetes may also attend support groups offered through diabetes education programs or visit support groups on the Internet.

Adjusting to new foods and routines and balancing new life changes can be trying at best but, as Steele emphasizes, patience, perseverance and a positive outlook can be powerful allies in the process.

“You just kind of have to take it a step at a time and see what works for you and not get discouraged ... It’s a learning experience,” she said.

This article includes information from the American Diabetes Association and the National Institute on Aging.

— Tamera Manzanares writes for the Aging Well program and can be reached at tmanzanares@nwcovna.org. Aging Well, a division of Northwest Colorado Visiting Nurse Association, is a community-based program of healthy aging for adults 50 and older. For more information, visit www.agingwelltoday.com or call 871-7606.

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