Did you know that type 2 diabetes (T2D) most often affects people over the age of 45? Though it can develop at any age, it tends to reveal itself right at a time when age-related changes (ahem, menopause) can make managing the condition more complex, according to Pouya Shafipour, M.D., a family and obesity medicine specialist in Santa Monica, California.
“As we get older, we naturally lose muscle mass and experience reduced metabolism function,” he says. “Shifts like these not only can contribute to the development of diabetes, because of how they affect insulin in the body, but also make it more challenging to manage the condition if you have it.”
The Centers for Disease Control and Prevention (CDC) report that more than 37 million Americans have diabetes, and up to 95 percent of them have T2D. The condition can cause serious complications—including heart disease, hearing loss, nerve damage, chronic kidney disease, and other issues. While diabetes is not curable, it can be well managed with consistent lifestyle habits, says Dr. Shafipour.
“Diabetes can affect physical and mental health, and addressing that through diet, exercise, sleep, and stress reduction is critical,” he adds. Use this guide to help you manage your diabetes and prevent comorbidities from occurring.
The effect that aging has on your type 2 diabetes
On its own, aging can raise a breadth of health risks, from cardiovascular disease to osteoarthritis to dementia, and the World Health Organization notes that as you get older, you’re more likely to experience several conditions at the same time—whether you’re living with type 2 diabetes or not.
Inflammation is a root cause for many of these issues, and diabetes can worsen it. “Simply having diabetes puts you in a higher risk category for a range of diseases, including heart disease, cancer, and Alzheimer’s,” Dr. Shafipour says. That means as you get older, T2D management isn’t just about keeping your blood sugar in check—it’s a major way to lower significant health risks.
Lifestyle pillars of type 2 diabetes management: Are you doing them?
Although you’re likely managing your condition with some medication, you probably know that how you move through life goes a long way toward making that medication work more effectively as well as improving your health overall, says Dr. Shafipour. Here are the areas to focus on most:
Exercise is crucial for managing T2D, because being active makes your body more sensitive to insulin. Physical activity also helps control blood sugar levels and may contribute to lower cholesterol, deeper sleep, and better weight maintenance. There are some considerations for exercising safely when you have T2D because blood sugar can drop with some exercise; that's why the CDC recommends checking blood sugar before exercising, and eating a carbohydrate-rich snack if your level is below 100 mg/dL.
When you were diagnosed, changing how and what you ate was probably one of the most notable things you had to do. As you age, sometimes your body doesn’t respond to foods in the same way; and as you know, there’s no one-size-fits-all diabetes diet. That’s why it’s helpful to get input from a diabetes educator on your health team, or another nutrition professional. In general, the key is to eat a variety of foods, especially low-sugar ones with fiber (such as fruits, vegetables, whole grains) and lean protein (such as soy, poultry, and nonfat or low-fat dairy).
Any type of chronic disease, including T2D, can feel isolating. Research suggests social interaction, especially when supportive and positive, can be a boon for better diabetes control—in part because it helps maintain motivation to continue any diet and exercise changes you may make. It’s also essential for helping reduce risk of depression and other mental health symptoms, which can be part of having T2D.
When you feel stressed, it can change your hormone regulation and cause your blood sugar levels to fluctuate. Stress can also sabotage sleep, which is another variable that can affect how well you’re able to manage your T2D. Finding ways to reduce stress—for example, through exercise, mindfulness, or a gratitude practice—can have a positive ripple effect on your type 2 diabetes.
Management is a lifelong endeavor. But the more emphasis you put on lifestyle habits like these, the more likely it will be that the physical and mental effects of the disease can be handled.
What to consider when choosing your type 2 diabetes treatment
A major component of T2D is your working relationship with your healthcare team. Knowing what to discuss with them can be helpful for making the most of your appointment time together. Here’s what should be on the agenda, according to Michelle Ogunwole, M.D., a professor of medicine in Baltimore, Maryland.
Short-term and long-term management plans that combine all aspects of care, including the ways lifestyle changes may affect your medication schedules and dosages.
Health goals, which include both keeping daily blood-glucose levels within a certain target range and setting lifestyle goals—for example, wanting to run a 5K or establish a consistent sleep schedule.
Specifics of daily T2D management, such as fully understanding blood-sugar readings and how to monitor glucose.
Managing medication side effects, which may result in trying different options if your treatment is too disruptive to your everyday life.
Finally, don’t hold back about the emotions and physical sensations you’re experiencing. “If you’re feeling stressed or frustrated, that can affect your condition and how it’s managed,” Dr. Ogunwole notes. “As difficult as it might be, it’s important to talk about how you feel. That could change aspects of your care plan.”
Preventing comorbidities of type 2 diabetes
Sometimes the most bothersome part of living with T2D is the other conditions that it makes you susceptible to. By remaining diligent with your lifestyle and treatment adherence, you can help lower risk of comorbidities such as:
Cardiovascular Issues (including high cholesterol, high blood pressure, and heart disease)
Certain Cancers (such as diabetic retinopathy, macular edema, cataracts, and glaucoma)
Depression and Anxiety
Certain factors, like your genetically inherited comorbidities, can’t be prevented when you have T2D—but you can take steps to significantly lower your risk of complications as you get older. Preventing these comorbidities takes the form of consistent condition management with a long-term plan that’s tailored to your situation, says Dr. Shafipour.
Assembling the right care team
Checking in with your endocrinologist or primary-care doctor on a regular basis is important for catching any issues early. But those aren’t the only people on your care team. In fact, tapping into a health system’s resources can be a significant boost for your ability to manage your type 2 diabetes. These include:
Professionals such as social workers, physical therapists, patient advocates, registered dietitians, diabetes educators, nurse navigators, psychologists, and financial experts.
Other specialists depending on your situation, such as a cardiologist if you have heart issues, or an ophthalmologist if you’re experiencing vision problems.
A “team leader” who can coordinate care; this is usually your endocrinologist but may be someone else, like a nurse navigator.
Because of the way type 2 diabetes can raise health risks and come with serious complications, managing the condition effectively may feel like a job. Yet it comes with notable benefits; namely better quality of life, including a higher level of physical and mental health. Putting in the time and effort to combine treatments like pharmaceuticals with lifestyle habits can make a difference and can lead to living well with T2D, no matter your age.
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