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Geriatric diabetes

Aging well with this health condition

by LAWRENCE VARGA and JOSEPH HANNA

You’ve made it to your golden years, and you now qualify for the senior discount at most places along with government drug benefits.

Growing older may have its own set of health challenges, including geriatric diabetes. Statistically, more than a quarter of all seniors have been diagnosed with diabetes, a disease that can take an average of a decade off of a lifespan. Fortunately, older adults can overcome the challenges of this disease with the help of their health care team, including their Costco pharmacist, family and friends.

Common symptoms of diabetes, such as increased thirst and urination, may not be present in older adults. Instead, they may experience dry mouth, dry eyes and confusion.

Some of the common diabetes drugs like metformin and a class called sulfonylureas—such as glyburide—can cause more problems than they prevent in the elderly, whose livers or kidneys may not be working as well as when they were younger, and are often avoided. Depending on the severity of the impairment of those organs, sulfonylureas can result in severe hypoglycemia (blood sugars that are too low) and subsequent dizziness, fainting and falls.

Those with additional medical conditions, such as difficulty walking and performing basic activities of daily living, fall onto the frailty scale, where a more cautious approach to treating diabetes is taken. While we aim for certain blood sugar and A1C results, which are similar to a three month-average of blood sugars in those with diabetes, we individualize these targets and allow higher levels for those who are frailer to prevent complications.

Seniors with cognitive difficulties will need help with all the monitoring that comes with diabetes, such as a blood glucose monitoring or taking a complex regimen of medications, which a Costco pharmacist can assist with through the use of a compliance pack that shows photos of the medication and organizes them by what time they should be taken. Due to lack of sensation in the nerves of the feet, another key step in monitoring the health of people with diabetes is conducting regular foot inspections to look for signs of injury, infections or ulcers.

On a positive note, newer, long-acting insulins have helped those with diabetes control their sugars better and with less side effects of hypoglycemia.

You may have heard the expression that growing old is not for the faint of heart, but this additional bit of knowledge may help you or your loved ones be better prepared to work with resources to manage this disease.

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Pharmacies in Costco’s Quebec locations are independently owned and operated by pharmacists.

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