Diabetes, such a widespread disease… and yet ultimately misunderstood! So what exactly is diabetes? And where does it come from? This refers to hyperglycemia that has become chronic, that is to say an abnormally high level of sugar in the blood. Thus, if a healthy person has approximately between 0.7 and 1.1g of sugar per liter of blood on an empty stomach (below, we then speak of hypoglycemia, another potentially very dangerous phenomenon, but much rarer and occurring most often in insulin-treated diabetic patients), a higher level is characteristic of hyperglycaemia. This can be transient but also chronic. Only then do you have to deal with diabetes.
There are two types of diabetes. Type 1 diabetes is generally detected early because above all associated with genetic factors leading to low production of insulin, the hormone allowing cells to store glucose, which is then found in abundance in the blood and causes hyperglycemia. However, it only affects about 10% of people with diabetes.
Much more common is type 2 diabetes , the origin of which is more often environmental than genetic, that is to say linked to the lifestyle of the patients – although genetic predispositions may be taken into account. Extremely widespread, it is estimated that it will soon affect one in ten French people. More than 4 million of us are already affected by it, and a significant part of these diabetics is not diagnosed. On a national and global scale, it represents a real public health problem, which prevention efforts do not succeed in stemming. Type 2 diabetes generally manifests later than type 1, and therefore results above all from a harmful lifestyle, with a lack of physical activity on the one hand, and a diet too rich in fat, sugar and salt on the other.
If diabetes represents such a public health problem, it is because hyperglycemia triggers serious complications in patients who have it. Cardiovascular diseases are thus much more frequent in diabetics, whose risk of having a heart attack or a stroke are 2 to 4 times higher, the high level of glucose in the blood contributing to its coagulation - a level which is of course not also increase with age, making seniors with diabetes even more at risk.
Diabetes also causes visual disturbances that can lead to complete blindness. The nerves are also affected, leading to poor healing in the event of trauma, which leads in the most extreme cases to amputations, especially of the foot. Similarly, a diabetic patient will be more susceptible to infections of all kinds, including kidney complications specific to diabetes. In general, it is the entire immune system that is weakened by a glycemic imbalance; this is also why diabetics who have contracted Covid-19 are more likely to experience a severe development of the disease. Finally, men – moreover more affected than women by this pathology – will be more likely to be victims of impotence, again increasing with age.
In short, diabetes, if it is unfortunately common, should certainly not be taken lightly, especially since a diagnosis is most often without return. There is no real cure for diabetes:it is simply in remission, and that at the cost of quite drastic life changes. It is estimated that diabetes causes a loss of about six years of life expectancy, compared to a healthy subject.
However, blood sugar levels tend to increase with age, which makes seniors particularly vulnerable to the development of type 2 diabetes. The sedentary lifestyle specific to developed countries and which only increases with age and the loss of mobility that sometimes accompanies it are also involved. Physical activities and sports, which play a role in preventing the development of type 2 diabetes, are abandoned by many seniors when their physical abilities decline. Yet it is precisely at this age that diabetes really begins to wreak havoc. In addition to the aforementioned complications, to which the elderly are already overexposed, we should also mention Alzheimer's disease, since the two disorders are said to favor each other mutually.
First of all, you should know that type 2 diabetes usually remains asymptomatic for many years. It is therefore difficult to detect it. Nevertheless, one of the first clues is a strong thirst accompanied by an abnormally high need to urinate. This is due to the poor absorption of water by the tissues due to the blood sugar level. These are therefore symptoms to keep in mind, as they are indicative of the disease. This is generally followed by a certain lethargy felt as chronic fatigue, since the sugar is no longer properly absorbed by the body, as well as a surprisingly developed appetite, which can nevertheless be accompanied by a loss of weight, a priori paradoxical. Finally, slow healing, numbness and/or tingling in the extremities are other factors of already well-developed diabetes. When these symptoms appear, the safest thing is to consult your doctor, who will be able to decide on a fasting blood test, in order to detect possible diabetes.
One of the main problems in detecting diabetes in the elderly is unfortunately the confusion of these symptoms with those related to simple aging. The blindness it gradually causes is, for example, typically perceived as a simple consequence of age. However, this loss of faculties under which diabetes hides is however most often greatly accelerated by the latter! This is why it sometimes enjoys several years to develop in peace, before finally being detected. However, the earlier the screening is carried out, the easier it is to put in place an appropriate treatment – and relatively light and livable – in order to stem it, and to observe a remission of the disease. So-called "recent" type 2 diabetes, that is to say declared less than ten years ago, would thus be treatable without medication.
Whether you are young or old, there is a holy trinity to respect in diabetics:take care of your diet, maintain regular physical activity, and manage your stress. Easier said than done for the latter in particular, especially at an age when major upheavals (retirement, widowhood, loss of loved ones, reduction in physical and cognitive abilities, etc.) are likely to plunge the elderly into depression and anxiety, but activities such as meditation or yoga can help reduce this.
In terms of food, it is necessary to reduce carbohydrate intake as much as possible and increase fiber intake. It is, however, a very rustic diet, and it is well known that older, more fragile people must be careful when it comes to undertaking diets. The priority is therefore the elimination of the most unhealthy elements, such as sweets for example.
The same goes for physical activity. Those recommended for younger diabetics in order to regulate blood sugar levels, such as intense endurance activities and weight training, are obviously not suitable for older people. For these, it is above all necessary to avoid excessive sedentarization as much as possible – a vice which is moreover considered by the WHO to be as harmful as smoking or alcohol consumption. Walking is therefore recommended, as well as daily physical activities, for example gardening if you have a garden. This is an opportunity to start dancing or hiking! Even slight weight loss through increased physical activity and attention to diet can have an extremely beneficial effect on the development of the disease.
It all really depends on how advanced your diabetes is, as well as your overall health, with all seniors being far from equal in this regard. To determine the most appropriate treatment, it is of course imperative to discuss it with your doctor. He will also be able to decide whether or not to take medication:before insulin supplementation, which the general public often associates with diabetes, there is a whole range of medications aimed at restoring the body's sensitivity to insulin it produces naturally. The treatment will depend on the form of each:in the most dependent elderly people, the main aim will be to improve the quality of life by avoiding severe complications, without setting unachievable objectives. The healthiest can be treated in the same way as younger patients, with therefore a chance of remission. To avoid this, it is still better to pay attention to your lifestyle... and unfortunately to have been lucky in the genetic lottery!
