Managing the ABCs of Diabetes in Older Adults
The most common form of diabetes in older adults is type 2 diabetes, which accounts for 90 to 95 percent of all diagnosed cases of the disease. May is Older Americans month and older adults have a higher rate of the disease, which is marked by higher than normal blood sugar levels. Research shows three are effective ways to prevent and manage type 2 diabetes.
Balintfy: In the United States, more than 12 million adults aged 60 and older have diabetes. That's about one out of every four older Americans. Experts point out that this age group has the highest rate of diabetes. What’s worse:
Fradkin: About a quarter of the people who have type 2 diabetes don't know that they have it.
Balintfy: That’s Dr. Judith Fradkin. She's the Director of the Division of Diabetes Endocrinology and Metabolic Diseases at the National Institute of Diabetes and Digestive and Kidney Diseases. She stresses the importance of getting tested.
Fradkin: And since this is Older Americans Month, it’s important to know that Medicare does cover testing for type 2 diabetes, which will also uncover people who are at high risk for type 2 diabetes. So, people should be tested as they get to be over age 45, but maybe even earlier, for sure earlier, if you’ve had gestational diabetes, also if you have a family history of diabetes, or if you belong to a racial or ethnic group that puts you at increased risk for diabetes, because you can’t do all the things to take care of your diabetes that can prevent you from getting the complications if you don’t know you have the disease to begin with.
Balintfy: Health problems associated with diabetes include heart disease, stroke, blindness and kidney failure. But Dr. Fradkin emphasizes that these can be avoided.
Fradkin: We know that controlling sugar, and blood pressure, and cholesterol dramatically reduces the risk of diabetes complications. And so there are goals for the control of those factors.
Balintfy: Goals to manage diabetes can be set by discussing the ABCs of diabetes with a doctor. Dr. Fradkin explains that the diabetes ABCs are A, for A1C blood test, B, for blood pressure and C for cholesterol. She adds that measures for these should be individualized.
Fradkin: So, for people who've had longstanding diabetes and are at very high risk of heart attack or stroke, a doctor may be less aggressive about treating the A1C, particularly if it requires a lot of different medications. On the other hand, if you’re newly diagnosed with diabetes, and you don’t have any complications, and you’re relatively easy to treat because you’re early in the course of diabetes, a doctor may be more aggressive and aim for an even lower A1C.
Balintfy: The general goal for the A1C test is 7. A target blood pressure is 130 over 80.
Fradkin: There are general goals for people based on clinical trial results, but it's also a question of how much medication and what side effects a person is having, so the treatment needs to be individualized, but again, if you control your weight, and that doesn’t mean getting down to your ideal body weight, but if you even lose 10 or 15 pounds, you will find that your blood pressure is better controlled with less medication.
Balintfy: A target for LDL cholesterol is less than 100. For more details about managing the ABCs of diabetes in older adults, visit the website, www.YourDiabetesInfo.org, or call, 1-888-693-NDEP. This is Joe Balintfy, National Institutes of Health, Bethesda, Maryland.
About This Audio Report
Reporter: Joe Balintfy
Sound Bite: Dr. Judith Fradkin
Topic: diabetes, type 2 diabetes, managing diabetes, ABCs of diabetes, older adults, older Americans, diabetes risk, controlling diabetes, Medicare, A1C, blood pressure, cholesterol