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AgePage

National Institute on Aging

Diabetes in Older 

People

Diabetes is a serious disease, and it 

affects many older adults. People get 

diabetes when their blood glucose, also 

called blood sugar, is too high. The good 

news is that you can take steps to delay 

or prevent type 2 diabetes, which is the 

most common form of the disease to 

develop in older adults. If you already 

have diabetes, there are steps you can 

take to manage the condition and prevent 

diabetes-related health problems. 

What Is Diabetes? 

Our bodies turn a lot of the food 

we eat into sugar, called glucose, which 

gives us energy. To use glucose as energy, 

our body needs insulin, a hormone that 

helps glucose get into our cells. If you 

have diabetes, your body may not make 

enough insulin, may not use insulin in 

the right way, or both. That can cause too 

much glucose to stay in the blood, which 

can cause health problems over time. 

Your family doctor may refer you to a doctor 

who specializes in taking care of people with 

diabetes, called an endocrinologist. Often, 

your family doctor will work directly with 

you to manage your diabetes.

Types of Diabetes 

There are two main kinds of diabetes. 

■ In Type 1 diabetes, the body does not 

make insulin. Although older adults can 

develop this type of diabetes, it begins most 

often in children and young adults, who 

then have diabetes for life.

■ In Type 2 diabetes, the body does not 

make or use insulin well. It is the most 

common kind of diabetes. It occurs most 

often in middle-aged and older adults, 

but it can also affect children. Your chance 

of getting type 2 diabetes is higher if you 

are overweight, inactive, or have a family 

history of diabetes. Women with a history 

of gestational diabetes (a type of diabetes 

that develops during pregnancy) also 

have a greater chance of developing 

type 2 diabetes later in life. 

Diabetes can affect many parts of your 

body. It’s important to manage diabetes 

because, over time, it can cause serious health 

problems like heart disease, stroke, kidney 

disease, eye problems, and nerve damage 

that may lead to amputation. Also, people 

with type 2 diabetes may be at greater risk for 

cancer and Alzheimer’s disease.
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What Is Prediabetes?

Millions of older Americans have 

“prediabetes.” This means their glucose 

levels are higher than normal but not 

high enough to be called diabetes. People 

with prediabetes have a greater chance of 

developing type 2 diabetes and having a 

heart attack or stroke. 

If you have prediabetes, there are 

things you can do to prevent or delay 

getting type 2 diabetes. Losing weight may 

help. Healthy eating and being physically 

active can make a big difference. Work 

with your doctor to set up a plan to help 

you make healthier food choices and get 

regular exercise. Get help with quitting 

smoking (if you smoke), because smokers 

are more likely than nonsmokers to 

develop type 2 diabetes. Make sure to ask 

how often you should have your glucose 

levels checked. Your doctor may also talk 

with you about taking medication to delay 

or prevent type 2 diabetes.

Symptoms of Type 2 Diabetes

Symptoms of type 2 diabetes may 

include feeling tired, increased hunger 

or thirst, losing weight without trying, 

urinating often, or having trouble with 

blurred vision. You may also get skin 

infections or heal slowly from cuts and 

bruises. Some people with type 2 diabetes 

may not realize they have it because 

symptoms often develop slowly and 

go unnoticed. Sometimes older adults 

dismiss these symptoms as “getting 

old,” but they can be signs of a serious 

problem. Talk with your doctor if you 

have any of these symptoms. 

Tests for Diabetes

Doctors use several blood tests to help 

diagnose diabetes: 

■ Random plasma glucose test—given 

at any time during the day 

■ A1C test—given at any time during 

the day; shows your average glucose level 

for the past 3 months 

■ Fasting plasma glucose test—taken 

after you have gone without food for at 

least 8 hours 

■ Oral glucose tolerance test—taken 

after fasting overnight and then again 

2 hours after having a sugary drink (This 

is not regularly given for type 2 diabetes.)

Your doctor may want you to be 

tested for diabetes twice before making a 

diagnosis. 

Managing Type 2 Diabetes 

Many people with type 2 diabetes 

can manage their blood glucose levels 

with diet and exercise alone. Others may 

need diabetes pills or insulin injections, 

along with medicines to manage other 

conditions like high blood pressure and 
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high cholesterol. Over time, a person 

with diabetes may need both lifestyle 

changes and medication.

Once you’ve been told you have 

diabetes, a healthcare team will work with 

you to create a diabetes management 

plan. Your plan will be based on your 

lifestyle, preferences, health goals, and 

other health conditions you have. 

As part of your plan, your doctor 

may prescribe one or more medications. 

Other healthcare professionals may also 

be involved. For example, a diabetes 

educator may help you understand 

diabetes and provide support as you 

make lifestyle changes to manage your 

diabetes. A dietitian may help with meal 

planning. An exercise coach may help 

you become more physically active.

Your diabetes management plan will 

cover how to: 

■ Track your glucose levels. Very high 

glucose levels (called hyperglycemia) or very 

low glucose levels (called hypoglycemia) can 

be risky to your health. Your plan will show 

how often you should check your glucose 

and how often to get the A1C test. If you 

are managing your diabetes without taking 

insulin, you may not need to check your 

glucose as often.

■ Make healthy food choices. The 

food you eat affects glucose levels, so it’s 

important to learn what’s best for you 

to eat, how much, and when. If you are 

overweight, work with your healthcare team 

to come up with a plan to lose weight. 

■ Be active. Walking and other forms of 

daily exercise can help improve glucose 

levels in older people with diabetes. Set 

a goal to be more active most days of the 

week, and create a plan for being physically 

active that fits into your life and that you 

can follow. Your healthcare team can help. 

For exercise information and examples, visit 

the National Institute on Aging’s Go4Life®

website at https://go4life.nia.nih.gov or call 

1-800-222-2225 (toll-free).

■ Take your medicines. You should take 

medicine as prescribed even when you feel 

good. Tell your doctor if you have any side 

effects or cannot afford your medicines. 

Also, let your doctor know if you have 

trouble taking your medicine or keeping 

track of your medication schedule.

Diabetes and Brain Health

If you have diabetes, your doctor 

may screen you for depression or 

cognitive impairment. Older adults 

with diabetes are at higher risk 

for these conditions, compared 

with others their age who do not 

have diabetes. Having depression 

or cognitive impairment can make 

diabetes self-care challenging.
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Here are some ways to stay healthy 

with diabetes:

■ Manage your blood pressure. Get 

your blood pressure checked often. 

■ Manage your cholesterol. At least 

once a year, get a blood test to check your 

cholesterol and triglyceride levels. High 

levels may increase your risk for heart 

problems.

■ Stop smoking. Smoking raises your 

risk for many health problems, including 

heart attack and stroke. 

■ Have yearly eye exams. Finding and 

treating eye problems early may keep 

your eyes healthy. 

■ Check your kidneys yearly. Diabetes 

can affect your kidneys. Urine and blood 

tests will show if your kidneys are okay. 

■ Get flu shots every year and the 

pneumonia vaccine. A yearly flu shot will 

help keep you healthy. If you’re over 65, 

make sure you have had the pneumonia 

vaccine. If you were younger than 65 when 

you had the pneumonia vaccine, you may 

need another one. Ask your doctor. 

■ Care for your teeth and gums. Brush 

your teeth and floss daily. Have your 

teeth and gums checked twice a year by a 

dentist to avoid serious problems. 

■ Protect your skin. Keep your skin 

clean and use skin softeners for dryness. 

Take care of minor cuts and bruises to 

prevent infections. 

■ Look at your feet. 

Ask someone else to check your feet 

if you can’t. If you have sores, blisters, 

breaks in the skin, infections, or buildup of calluses, see a foot doctor, called a 

podiatrist. 

■ Keep up with cancer screenings.

Ask your doctor which screenings to get 

based on your age, gender, and other 

risk factors. 

■ Talk with your doctor about your 

concerns. If you think you might need 

help with your management plan, are 

depressed, are worried about your 

memory, or have any other concerns, 

talk with your doctor. There may be 

ways to help. 

At least once a year, your healthcare 

team will assess how well you are managing

your diabetes. Your management plan 

might need changes, or you may need 

more information and support. A change 

in health, such as a new diagnosis or 

complication, or a change in care, such 

as going home from the hospital, may 

also lead to changes to your diabetes 

management plan.

Be Prepared 

Make sure you always have at 

least 3 days’ worth of supplies on 

hand for testing and treating your 

diabetes in case of an emergency.
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Help with Diabetes Costs

Medicare may pay to help you learn 

how to care for your diabetes. It may also 

help pay for diabetes tests, supplies, flu and 

pneumonia shots, special shoes, foot exams, 

eye tests, and meal planning. For more 

information about what Medicare covers, 

call 1-800-633-4227 (1-800-MEDICARE) 

or visit www.medicare.gov.

For help paying for diabetes 

medications and supplies, go to 

www.diabetes.org/living-with-diabetes/healthinsurance/prescription-assistance.html.

For More Information on 

Diabetes

American Diabetes Association

1-800-342-2383 (toll-free) 

askada@diabetes.org 

www.diabetes.org

Centers for Disease Control and 

Prevention

1-800-232-4636 (toll-free) 

1-888-232-6348 (TTY/toll-free) 

cdcinfo@cdc.gov

www.cdc.gov/diabetes/home/index.html

National Institute of Diabetes and 

Digestive and Kidney Diseases

1-800-860-8747 (toll-free)

1-866-569-1162 (TTY/toll-free)

healthinfo@niddk.nih.gov

www.ndep.nih.gov 

www.niddk.nih.gov/health-information/diabetes

Smokefree.gov

1-800-784-8669 

(1-800-QUITNOW/toll-free)

cancergovstaff@mail.nih.gov

www.smokefree.gov

https://60plus.smokefree.gov

For more information on health and 

aging, contact: 

National Institute on Aging 

Information Center 

1-800-222-2225 (toll-free) 

1-800-222-4225 (TTY/toll-free)

niaic@nia.nih.gov

www.nia.nih.gov

Visit www.nia.nih.gov/health to find 

more health and aging information 

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Visit https://order.nia.nih.gov to order 

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National Institute

on Aging

NIH...Turning Discovery Into Health®

April 2019