Aging and diabetes are both risk factors for functional impairment (the opposite of functionality). People with diabetes have approximately a doubled risk of suffering a functional disability versus non-diabetics, and for diabetics aged over sixty-five they have a four-fold risk due to both their diabetes and the subsequent effects of aging on the body. Older adults with diabetes are at high risk of polypharmacy, increasing the risk of drug side effects and drug-to-drug interactions.
A challenge in treating type 2 diabetes is that polypharmacy may be intentional and necessary to control related comorbidities and reduce the risk of diabetes complications or medication errors – such strategies are a must in senior assisted living or other long term care facilities where chronic medications must be sustained over the lifetime of an individual with limited health resources. Sensory impairments should be considered when educating older adults and supporting their self-care. Nearly one in five older U.S. adults with diabetes report visual impairments that limit their daily functioning; however less than half of those needs are met with visual aids such as corrective lenses and other vision devices and there are major disparities in access to adequate eye care services in the U.S.
There is a need to increase awareness and education among family caregivers on early detection and prevention of diabetes. Risk factors include decreased mobility secondary to peripheral vascular disease which is common in people with diabetes. On the other hand, nutrition is an integral part of diabetes care for all ages, but there are additional considerations for older adults with diabetes. The CDC has outlined that older people should be screened once a year to detect problems before they become serious enough to prevent someone from being able to function independently at home. Diabetes health care and services tend to be fragmented making self-management difficult and increased health care costs resulting from these inequalities in areas such as limited access and lack of Medicare coverage for those at greatest need—low income minority seniors.
Adding to the burden is the fact that nearly half the U.S. population over the age of eighteen is obese and many face barriers to getting screened for diabetes and obtaining the necessary treatment and follow up assessment following a diagnosis unless prompted through an educational outreach program designed to identify individuals at risk in their community who are then subsequently identified and offered early intervention and education about living with the disease to reduce their risks for developing comorbid illnesses.
