Diabetes occurs more frequently with advancing age, especially for persons who become more sedentary with age. There is an increase in fatty tissue and a decrease in muscle mass with age, which accompanies a decrease in physical activity. The elderly person with diabetes may be affected by other illnesses, known as comorbidities and the use of many medications, known as poly-pharmacy. Hypoglycaemia may occur more often due to liver and kidney disease and also due to hypoglycaemic unawareness. Hypoglycaemia can affect functioning and vision and can increase falls and fractures; complications of diabetes may also be more frequent, such as kidney dysfunction and heart disease. Our elderly persons with diabetes may benefit from a less restrictive meal plan with a level and intensity of physical activity dependent on physical condition. Insulin is often required for elderly persons with diabetes and this requires family involvement and and support, and self monitoring of blood glucose at home.
Diabetes and Children
The diagnosis of diabetes at a young age is particularly difficult for the child or adolescent and for his or her family. In most cases the diagnosis is type 1 diabetes; but increasingly type 2 diabetes is being diagnosed with a link to childhood obesity. The symptoms are similarly:
- Increase thirst
- Fatigue weight loss
- Blurred vision
- or even yeast infections in young girls.
A delay in diagnosis may be fatal, so please know what to look for. Diabetic ketoacidosis results from a build up of ketones in the blood, when the body is unable to make glucose from energy and this may be fatal.
Additional issues for younger persons with diabetes include:
- Fear of gaining weight while using insulin which can result in anorexia or bulimia in extreme cases.
- Self control issues with meals especially hidden sweets, abuse of alcohol, smoking or both, which may affect blood glucose levels.
- Peer pressure and wanting to appear like their peers may lead to avoidance of insulin injections and diabetes control may not be a priority.
Parents often need to learn insulin injection techniques and to know about hypo- or hyperglycaemia. They need to know how to adjust the insulin with meals and physical exercise and what to do on days of illness known as sick days. Family support and access to a health team are important for diabetes and children.