Managing Diabetes as a Senior

Better nutrition, exercise still key to controlling diabetes

By Deborah Jeanne Sergeant

Managing Type-2 diabetes as an older adult is a little more complicated than with younger people. Often by this stage in life, other health issues have arisen. Doctors tell diabetic patients to exercise. However, by this stage of life, more limited mobility from arthritis or injuries can make it more challenging to work out. The care for other health conditions can make it difficult to take on all of the care necessitated by diabetes, such as managing blood pressure and cholesterol, smoking cessation, annual eye exams, careful foot care, annual urine and blood tests for kidney health and dietary changes.

“Management includes lifestyle modifications, diet, exercise, smoking cessation, treating hypertension and dyslipidemia, keeping medical appointments, and medication management if needed,” said Julie Mellen registered dietitian Upstate Medical University.

Seeking help from a certified diabetes educator can assist in managing the various aspects of the condition, including dietary changes, which many consider the most difficult aspect of management. Some patients may find it difficult to make in-office visits. However, most insurances cover virtual visits.

“Avoiding hypoglycemia, low blood glucose, is very important,” Mellen said. “Older adults are more vulnerable to low blood sugars and may not feel the symptoms as well. Low blood glucose can result in a higher risk of falls, fractures and adverse cardiac risk.”

Ideally, pairing high fiber meals with protein helps stabilize blood sugar. Some older adults find difficult the dietary changes brought by Type-2 diabetes, particularly if they’ve never cooked much or at this point in life, find cooking difficult.

Mellen recommends MyPlate for Diabetes, which indicates filling half of a standard nine- or 10-inch plate with non-starchy vegetables raw or cooked, and the other half of the plate with lean protein and carbohydrate foods, about one-quarter each.

“Incorporate more whole grains and less refined grains,” Mellen said. “Include two to three servings of fruit daily and two to three servings of dairy or alternative. Choose healthy fats in moderation.”

Any snacks should pair carbohydrate sources with protein sources, such as fruited yogurt, cheese or cottage cheese with a whole grain cracker or peanut butter on slices of