The Effects of Diabetes on Aging Adults - Research Paper Example

? The Effect of Diabetes on the Aging Adult of College As adults become older, they are susceptible to many different diseases if they do not take good care of themselves. Diabetes is one of the diseases in older adults that is a serious condition and it can be deadly. It is important for these adults to understand the nutritional and exercise needs they must have in order to stay healthy. Diabetes can be managed effectively if older adults understand what they must do. The literature emphasized that education about the disease and the nutritional needs were important. This paper gives an understanding of diabetes in older adults and the needs for nutrition, exercise and care. The Effect of Diabetes on the Aging Adult As adults age, there are many factors that they must take into consideration to make sure that they age gracefully. Many adults find that as they age, they are met with issues that they may not have had when they were younger. As an example, adults who are not active will sometimes run the risk of arthritis and other bone or joint ailments. Their doctor may tell them that they must continue to do exercise because it will help some types of arthritis. Adults can also find that they gain weight easier or that weight is more difficult to take off as they grow older. These are natural aspects of aging, but they do not have to be long lasting. In looking at the area of nutrition and aging, this researcher has chosen to study the idea of diabetes in the aging population. Defining Diabetes Type 2 diabetes also known as adult onset diabetes, is a chronic condition and it affects the way that the body processes sugar or glucose, which is the body's main source fuel (Mayo Clinic, 2011). Basically, this means that a person's body has a resistance to the hormone insulin that is responsible for moving glucose through the body. Some people do not produce enough insulin to maintain a glucose level within normal ranges. Both of these conditions are a product of Type 2 diabetes. Although there is no cure for the disease, there are many ways that an individual can manage it. There are many symptoms that people may ignore because they may not create a problem for them. These symptoms include: 1. Increased thirst and/or frequent urination -- this happens when sugar builds up in the bloodstream. Fluid is taken from the tissues to compensate and this can result in the individual becoming very thirsty. 2. Increased hunger -- the muscles and organs lose energy when they do not have enough insulin and this increases hunger. 3. Lose of weight -- many people lose weight because the body does not use glucose properly. The body will use any fuel it can get which means it will look to what is stored in the muscles and fat. 4. Fatigue -- people with Type 2 diabetes often report that they are tired and irritable. 5. Blurred vision -- this is an indication that the sugar in the body is too high. When this happens, fluid is taken from the eyes so the vision is blurred. 6. Slow healing sores or frequent infections -- if this occurs it is best to talk to a doctor because it is a symptom that happens in people who have diabetes. 7. Areas of darkened skin -- people with Type 2 diabetes may find darkened areas in their armpits or around their neck. This could be a sign that the individual is resistant to insulin (Mayo Clinic). An individual is more likely to develop diabetes as they age if they fit into several categories: 1. They are over 45 years of age. 2. They have high blood pressure. 3. They are obese. 4. They have a family history of diabetes and are African American, Hispanic/Latino, American Indian, Alaska Native, Asian American or Pacific Islander. 5. Have blood vessel problems that affect their legs, heart or brain. 6. Have abnormal cholesterol (lipid) levels. (National Diabetes Education Program). Demographics of Older Adults with Diabetes When an adult is experiencing any of these symptoms, it is important for them to go to a doctor to find out whether they have diabetes. According to Gambert (2006) diabetes in the aging population is becoming an epidemic. It is estimated that there are at least 20 million adults living with diabetes in the United States with another 5 million undiagnosed. As people get older, they are more prone to diabetes. Half of the people with diabetes now are between the ages of 60 and 80 years. Diabetes is also the 6th largest leading cause of death with about 225,000 people dying of the disease each year (Gambert, 2006). Part of the reason this happens is because older people do not always receive counseling about proper nutrition or about the need for medication to help with diabetes. In 2011, according to the American Diabetes Association, 25.8 million children and adults have diabetes in the United States. At least 18.8 million have been diagnosed while 7.0 million have not been diagnosed. The total cost of diabetes to society in 2007 was $218 billion. For adults 60 and older, 10.9% or 26.9% had diabetes in 2010 (Centers for Disease Control, 2011). Diabetes is also the leading cause for kidney failure, a major cause of heart disease and stroke and is the seventh leading cause of death in the United States. Eating Habits of Older Adults There are many factors that affect the way older adults eat as they age. There are physiological changes in the body and there are environmental factors that may create challenges for older adults. Some older adults cannot shop for food as they once did and relatives may be reluctant to help on a regular basis. If older adults cannot cook for themselves, they may also rely on community organizations or on family members to do the cooking for them (Working Caregiver, 2007). There are also changes in the body that will make a difference in how older adults eat. The metabolism slows down after the age of 40 and people sometimes are less physically active. When these two things come together, it may mean that the adult retains weight instead of losing weight, even if they are eating the same amount of food. The senses begin to diminish. As an example, some seniors find that they cannot distinguish salty or bitter foods and sugary foods are the most satisfying. Also, medicine or certain illnesses can cause problems with taste and appetite. The digestive system also slows down which means that as people age, there is less saliva and stomach acid to break down the food. The body also has difficulty processing some vitamins and minerals, which may mean that seniors need to take a supplement or eat foods rich in certain vegetables and minerals (Kovatch and Kemp, 2011). Seniors can also fall into depression or loneliness which will also give them a tendency not to eat well. These habits can cause other problems and can lead to the symptoms of diabetes. Studies about Seniors and Diabetes As stated previously, Type 2 diabetes is a threat to older adults and there have been several studies done about what happens to cause this and the treatment that is done. Spencer (2010) conducted a study that provided insight through a case study as to the management of this disease. The study was designed to understand high blood pressure as it related to Type 2 diabetes in older adults. The study showed that it was a good idea for doctors to understand they must treat older people without prejudice and they should treat on the basis of evidence for this study. Djousse (2010) et al. studied the effects of egg consumption and its relationship to Type 2 diabetes in older adults. They used a questionnaire with 3,898 men and women and found that egg consumption could bring about diabetes in those who consumed who ate eggs daily. The reason this happened was because eggs drove their cholesterol up. The group that did not eat eggs at all did not have new incidences of Type 2 diabetes. The authors concluded that if the adult was susceptible to high cholesterol, that they were more susceptible to Type 2 diabetes. Fisher, De Frais, Yeung, and Dixon (2006) researched cognitive performance in older adults who had Type 2 diabetes. They had 272 participants in their study who took a neuropsychological battery of tests to understand what they were dealing with in terms of their cognitive processes. They studied the participants over a three year period. The studied revealed that cognitive speed was hampered so it took participants longer to do specific tasks that involved their thinking. This slowing down of cognitive factions led the researchers to think that this can also be an early sign of dementia which can be a long-term effect of diabetes in older adults. They did not find that the adults in the study had problems with declarative memory or problems with speech. However, Okereke et al. (2008) conducted another study of cognitive functioning. In their study, 12, 224 ,men and women between the ages of 71 and 75, some with diabetes mellitus, were analyzed for cognitive imparities. They found cognitive challenges in both memory and cognitive functioning. The longer the individual had diabetes mellitus, the more impaired their cognitive functioning became and they had problems with verbal memory. Their study also showed that these impairments were worse in women than in men. In these two studies, all patients were receiving treatment of some sort for diabetes and/or for high blood pressure and cholesterol problems. When people get older, they are also prone to other problems as stated previously. High blood pressure and problems with cholesterol are two that often occur. However, it seems that older adults are also susceptible to being prescribed with an overload of medicine that can have an affect on how they live. There are some studies that associate the amount of medication an individual takes with their susceptibility to falls. In a study by Huang, Karter, Danielson, Warton, and Ahmed (2010) it was found that the use of four or more medications can make older adults more susceptible to falls. In this study, the researchers tested to see how this fact affected adults with type 2 diabetes. The study was conducted over three years and the patients had a follow-up of five more years. The researchers found that in cases where there was no "glucose lowering agent" (p. 144) the adults were more prone to fall. They also found that many of those who had falls were less educated than others, more likely to have had diabetes longer, were older, and were most likely to have other challenges associated with diabetes. They found that those who were using more than four prescriptions were consistently more susceptible to falls than those who had less medication. This study supports the issue that medication may be hindering the quality of life for many older adults when not monitored properly. The Effects of Diet and Exercise on Diabetes in Older Adults In the United States, people have been inundated in the last couple of years with information about diet and nutrition. The information tells everyone how to eat and how to exercise in order to make sure they stay at the top health that they can. As adults become older, it becomes more difficult for some to get the exercise in that they need. It also becomes more difficult for older adults to eat properly as stated previously. However, it is very important for older adults to receive the amount of nutrition they need each day by eating good food. Also, it is important to receive adequate exercise. The first aspect for nutrition is for older adults to have education about the disease and how they should treat it. The educational component is very important in order for them to know what they should do and why they should do it. As an example, Miller, Edwards, Kissling, and Sanville (2002) created a randomized study that included 98 participants over the age of 65, who had Type 2 diabetes for at least one year. Their research provided an understanding of the impact that an education program could have that was geared towards older adults. If the adults who started the study, 92 finished. They found that those adults who had the education program were able to keep their glucose under control and therefore were able to have better metabolic control. Providing nutrition education along with the information on diabetes showed that all participants were able to maintain metabolic control over time. The importance of exercise has been commonly known and Tsai, Ford, Chaoyang, Guixiang, and Balluz (2010) studied the effects of exercise in older adults as an intervention for prevention of diabetes. The most important aspect of what they found was that exercise is very important to the older adult with diabetes because it gives them the opportunity to reach optimal health with their diabetes. The also state that regular exercise will affect most of the body systems and create an opportunity for some of the body to repair itself. It can also help those older adults who are prone to anxiety and depression to have a healthier mood. These studies show that there is a need for diet and exercise with older adults especially when they have Type 2 diabetes or any other type of diabetes. As with any other type of disease, having the opportunity to get up and move will benefit the entire body. When adults become older and they become more sedentary, it will be difficult for them to gain what they need in order to stay healthy. Life will not be lived as well when they are not taking care of themselves in a way that matters to their health. There are a variety of things that an older adult can do that will help them move and get out and enjoy life. The Nutritional and Exercise Requirements for Older Adults with Diabetes All adults and children have been told that they need to eat healthy foods and exercise on a regular basis in order to stay healthy. This is very important for older adults with diabetes as well. Niedert and Dorner (2004) suggest that there are five areas that must be met for nutritional therapy in older adults with diabetes. These five areas include: 1. Making sure that older adults receive adequate calories and nutrients. 2. Helping the older adult keep their glucose levels at the right levels recommended by their doctors. 3. Helping them manage any coexisting morbidities they may have (such as high blood pressure, high cholesterol, etc.) 4. Help them to "prevent, delay or treat" any complications that may happen because of their diet (p. 44). 5. Promote a quality of overall health and well-being. With these five areas in mind, it is important to understand that the needs of an older adult with diabetes is more expansive than the needs of older adults without diabetes, but the nutritional needs for good food will be the same. The American Diabetes Association (2011) suggests that nutrition is very important to the older adult with diabetes. They suggest that they should make sure they eat plenty of fruits and vegetables, non-starchy vegetables, who grains, dried beans, fish, lean meats, non-fat dairy, and drink a lot of water and calorie free drinks. They provide a list of specific foods on their website. The also suggest that there are several super foods that older adults with diabetes should eat. These foods are rich in vitamins A, C and E, fiber, calcium, magnesium, and potassium. Some of the super foods include beans, dark green leafy vegetables, citrus fruit, sweet potatoes, berries, tomatoes, nuts and whole grains. They do suggest that older adults stay away from sugar for the most part, but that they can eat small amounts of sugar if they plan for it in their daily intake. Central to eating nutritionally is making sure that there is an education program that older adults can go to in order to receive education about nutritional needs. This topic was talked about earlier in this paper, and it seems to be a recurring theme throughout the literature and sites that this researcher explored. An important tool to use it to learn how to read food labels. This will help the older adult understand what is in the food in terms of carbohydrates and sugars. The American Diabetes Association also states that movement is very important to the older adult with diabetes. They suggest finding a form of exercise that fits the individual's personality. As an example, some people enjoy walking, while others enjoy riding a bicycle, dancing, or going to a gym. The individual must pick something they enjoy. Starting small, with just 10 minutes a day can be very helpful and the individual should increase the time over a period of time. It is also important to think about what one can do during the course of a day. Sometimes taking the stairs may be more practical for some people instead of the elevator or changing the channel on the television without the remote. These are small things, but they can be very helpful to get someone up and moving. There are several benefits of exercising as well. Exercise can improve glucose management, lower blood pressure, relieve stress, make bones and muscles stronger and lower the risk of other health problems. Exercise can be done alone, at home, or with friends. Sometimes joining a recreation center can be a very good option for many seniors, especially if there are other seniors who go to the center. There are many programs at these centers that keep seniors in mind and there can be aquatic programs, fitness classes, a weight room and other seniors to interact with and become friends with over time. This can be an excellent alternative to going to a gym and can be less expensive. The Heart and Stroke Foundation of Canada (2009) reported on a study that suggests that aerobic exercise for older adults with diabetes can help them in just three months. The study suggests that physical activity can improve the elasticity in the arteries. This study observed adults between the ages of 65 and 83 who exercised, and those who did not. They found that those who exercised had more elasticity in their arteries which could decrease their risk for heart attack or stroke. Conclusion Every adult has nutritional and exercise needs but for older adults, this is a more mandatory situation than for others. As people age, there are different ailments that happen and that they must be able to see a doctor regularly to assist. Type 2 diabetes is one of these ailments. The population of older adults with diabetes is growing which means that most of us going into some form of health care will find that they will be working with older adults and helping them to regulate their diabetes. When this researcher things about working with older adults, there seem to be many issues that need to be taken into consideration when we are going to work in this area. One issue is that older adults need to be educated about diabetes and its impact on their lives. This education must be directly related to the older adult rather than to young children or younger adults. The studies show that educating them from their own standpoint allows them to have more investance in keeping up with their program. Also, older adults need to have some type of support system. If it is not family, then they need to be shown a way to make friends outside their family so they have some support in getting the exercise and nutrition they need. Perhaps there is a recreation center or day facility near them that they can go to in order to take classes or attend programs where other seniors also go. They may have a daily or weekly luncheon of nutritional food that would be perfect for their midday meal. These types of situations can help the older adult feel less isolated and give them something to look forward to during their week. Another issue is to make sure that they get care they need for hypertension or high cholesterol because these can be preliminary signs of Type 2 diabetes. The older adult, who has an opportunity for education about their diabetes and takes steps to eat well and exercise, will live a much longer life. References American Diabetes Association. (2011). Diabetes statistics. Retrieved from http://www.diabetes.org/diabetes-basics/diabetes-statistics/ American Diabetes Association. (2004). Nutrition principles and recommendations in diabetes. Diabetes Care. 2 (1). doi: 10.2337/diacare.27.2007.S36. Retrieved from http://care.diabetesjournals.org/content/27/suppl_1/s36.full Centers for Disease Control. (2011). Fast facts on Diabetes: National Diabetes fact sheet 2011. Retrieved from http://www.cdc.gov/diabetes/pubs/ factsheet11.htm?utm_source=WWW&utm_medium=ContentPage&utm_ content=CDCFactsheet&utm_campaign=CON Djousse, L., Kamineni, A., Nelson, T.L., Carnethon, M., Mozaffarian, D., Siscovick, D., and Mukama,K.J. (2010). Egg consumption and risk of type 2 diabetes in older adults. 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Physical activity and optimal self-rated health of adults with and without diabetes. BMC Public Health, 10, 365-373. doi: :10.1186/1471-2458-10-365 Working Caregiver. (2007). 10 Warning signs of aging relatives eating right. Working Caregiver: New Aging Practices for Care. Retrieved from http://www.workingcaregiver.com/articles/healthy-diet/seniornutrition Read More