Growing old is inevitable, but the road to aging can’t be that bad if we would only work towards facing old age with grace and living healthy in the process. The terms “healthy aging” and “aging gracefully” have slowly crept into our vocabularies in recent years to embrace the positive aspects of aging.”We always look at health in terms of holistic health – in body, mind and spirit. So healthy aging encompasses not just what is physical health but also psychospiritual and social dimensions of health, including having a good quality of life:’ says Dr. ShelleyAnn delaVega, a geriatric physician and president of the Philippine Society of Geriatric Medicine.

According to the data from the 2000 Census of Population and Housing, 4.6 million or 5.97 percent of Filipinos belong to the senior citizens group (60 years old and over). Advancing age, along with weight and genetics, is one of the risk factors for developing type 2 diabetes. All over the world, approximately eight percent of people over age 65 have diabetes. For the elderly with diabetes, aging can be as normal as for those without the disease. An elderly person can still live to the fullness of his being even with diabetes. One of the first steps in dealing with diabetes in old age is by understanding how diabetes affects the elderly.

Aging and diabetes
“Most diabetics are either in the middle age group or in the older age group,” says endocrinologist Dr. SusanYuGan, treasurer of the Philippine Diabetes Association (PDA). She explains that this is because as we grow older, the way our body handles sugar becomes more deficient, and that insulin production in
the pancreas and the uptake of glucose in the peripheral tissues become slower. These factors increase blood sugar as a person ages. Diagnosing diabetes in the elderly might be quite difficult because many elderly diabetics are asymptomatic, meaning they do not feel any symptoms at all. According to diabetologist Dr. Richard Elwyn Fernando of the Institute for Studies on Diabetes Foundation (ISDF), diabetes manifests slowly in the elderly, which is why no symptoms are felt in the beginning. In this case, Dr.YuGan says that screening, through blood sugar testing, is very important.

However, if an elderly has some of the so-called identifiable risk factors, then it will be easier to diagnose them. These so-called identifiable risk factors that include obesity, family history of diabetes, physical inactivity, and the presence of concomitant diseases like hypertension and cholesterol abnormality, increase a person’s risk of developing diabetes. Although some individuals may present with symptoms, doctors say it would still be difficult to identify symptoms as uniquely due to diabetes because some of these may be associated with aging. Frequent urination, for example, might be associated with prostate problems or dysfunctional bladder, explains Dr.Yu-Gan. Even vision problems may be thought of as just signs of aging, and thus, the person would not seek, or delay seeking medical attention.

Among the elderly, diabetes complications also tend to develop more quickly as a result of the long period before diagnosis. As such, older people may have more complications that may be more severe than in younger people. “Most of the time, unfortunately, when we get a diabetic in the later years, that’s the person who already has complications of diabetes,” said Dr. dela Vega, who is also head of the Center for Healthy Aging at The Medical City and chairperson of the Committee on Aging of the National Institutes of Health at the University of the Philippines in Manila.

According to Dr. dela Vega, a lot of elderly patients with diabetes seek medical help only when they already have other medical problems like painful extremities or diabetic nerve damage, abnormal digestion, vision problems and kidney disease. “Because diabetes prevalence increases as people age, we get more people with end-stage disease at this age group,” she says.

Part 2: Diabetes Management in the Elderly

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• percent of people having diabetes all over the world
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