Diabetes mellitus, commonly referred to as sugar diabetes, is one of the more prevalent chronic diseases particularly in Western nations. It is not specifically a disease of the elderly – in fact diabetes mellitus is more likely to develop within the mid forties to late fifties. However, some of the more severe complications in diabetes mellitus occurs closer to the senior years. It significantly complicates both the lifestyle and management of other diseases in the elderly. More importantly though, diabetes mellitus is potentially fatal and there is often ignorance about the seriousness of this disease.
There is broadly three types of diabetes mellitus :
Diabetes mellitus is simply a problem with controlling the blood glucose levels thereby leading to high glucose levels (hyperglycemia). Normally the pancreas secretes a hormone known as insulin to lower blood glucose levels should it rise. Another hormone known as glucagon can raise blood glucose levels when it falls too low. In this way the body can maintain the blood glucose levels within a normal range at any time of the day or night. Glucose is essential for the cells to produce energy and is needed for every process in the body to run efficiently. Most glucose is sourced by breaking down carbohydrates that are eaten but even protein and fat can be converted into glucose. High levels of glucose however can damage cells and lead to a host of complications.
The hormone insulin forces cells to take in more glucose and for excess glucose to be stored away in the liver as glycogen or throughout the body as fat. In this way insulin removes glucose from the bloodstream when the glucose levels are too high. It also signals the liver to not produce any additional glucose either from the food it is processing or its glucose stores. In diabetes mellitus this control of blood glucose levels by insulin is impaired. In type 1 diabetes mellitus the pancreas cells that produce glucose is damaged leading to a lack of insulin (insulin deficiency). With type 2 diabetes mellitus the cells of the body stop responding to the insulin and this is known as insulin resistance. A similar process to type 2 diabetes mellitus occurs in gestational diabetes possibly as a result of the high levels of female hormones in circulation during pregnancy.
Although genetic factors play a significant role in diabetes mellitus, the influence of other lifestyle factors particularly with type 2 diabetes mellitus are important considerations. This includes :
Apart from age and family history, most of the other factors are modifiable meaning that it can be changed or avoided.
Diabetes mellitus is initially asymptomatic meaning that there may be no signs and symptoms especially in the stage just before diabetes fully develops known as pre-diabetes. In the elderly, the signs and symptoms can often be mistaken for side effects of chronic medication or other diseases. Therefore it is important to undergo regular testing to monitor the blood glucose levels rather than depending on the onset of the various symptoms.
Over time and as the diabetes worsens, a person may start noticing additional symptoms such a repeated infections, wounds that do not heal properly or as quickly, blurred vision, unexplained headaches and fruity odor to the breath. Once the complications of diabetes mellitus sets in, more severe symptoms will become apparent.