The diagnosis used to be quite simple: If you were 65 or older and acquired diabetes, make sure your will was prepared because death was right around the corner. In the past, many times doctors were hesitant to give elderly patients insulin. Now, with nearly 10 million elderly diabetics in the U.S. alone, doctors and scientists are working to improve the life of these diabetics.
It used to be a death sentence for someone 65 or older. Being told you were a diabetic could mean it was only a matter of time.
However, changes in medical
technology, human longevity and profit-starved medical corporations have
created a huge difference in the techniques used to combat diabetes in the
elderly in the past, and techniques they use now and are planning to use in the
future.
Better Attitudes
According to a study by the
National Diabetes Information Clearinghouse in 2000, 7 million, or 20.1 percent
of all people 65 and over have diabetes. With a U.S. society still battling
obesity, those numbers don’t appear to be dropping.
Still, attitudes on
elderly diabetics have changed dramatically in recent years, said Carolyn Leontos, MS, RD, CDE
from the Cooperative Extension of the University of Nevada.
“Years ago, the thought of
putting an older adult on insulin wasn’t real common. Well, we now know people are
living longer,” Leontos said. “I think
we’re looking at things differently, we’re not writing people off at 65. These
people are getting a chance to live life to the fullest.”
Drug Companies Seeing the Light
For years, companies have
tripped over themselves to treat popular maladies. If you need to lose weight,
gain hair or have a more consistent erection, the large pharmaceutical
companies have the product for you if you have the money.
Unfortunately, many diseases get
left out in the proverbial cold. For many years diabetes was one of those diseases.
But now with the worldwide explosion of new diabetes’ diagnoses, drug companies
see huge profit potential for themselves. This has resulted in a recent spate
of new drugs aimed at the disease. Proving that drug companies are looking at
the $100 billion in health-care costs diabetics spend annually and deciding to
get their share.
For many elderly diabetics,
these drugs may not have a big effect, but in a future that could see a
disproportionately large elderly population with diabetes, the breakthroughs
could be huge, though some studies are showing they can have health risks.
The New Drugs
Actos, Glucovance, Avandia and
Rezulin are thiazolidinediones (TZDs), which are used for treating type 2
diabetes, in particular insulin resistance. Also known as
"glitazones," these drugs get around insulin resistance by making
muscle cells more sensitive to insulin.
In a 20-week clinical trial of
806 people with diabetes who were not taking any diabetes drugs, the
combination pill was shown to significantly lower blood glucose and contribute
to better diabetes control.
The occurrence of some cases of
liver damage has been a cause for concern among some, but
studies by Parke-Davis, the company that produces Rezulin have shown these
cases occur at a rate of one in every 57,000 users of the drug.
Leontos, a board member of National Diabetes Education Program
Steering Community, said the new drugs have opened many new doors.
“In 1995, we had oral
sulfonylureas, one class of drug to treat this disease. That was the name of
the game, that or insulin,” Leontos said. “Now we have a number of classes of
drugs, not only insulin, but we can tailor insulin to how your pancreas works.”
Still, for the elderly, these
drugs require the user to undergo liver testing to see if the patient is
susceptible to liver problems from them. Also, no data exists on the drug's
helpfulness with elderly patients, though the fact they work in muscle groups
would insinuate that loss of muscle mass would effect the drug's usefulness.
“Most of these things are not
age specific. But typically the older you get the more medication you take, the
more pills you take,” Leontos said. “The important thing is that with these
medications we can help people even if they are set in their ways. These can
address certain specific issues.
While the world of medicine
continues to make strides, the elderly should also strive to control
their diabetes with diet and exercise.
Also, these drugs are not suggested for patients with heart troubles
and they
contribute to water retention
Other Theories
Aside from drugs, other experts
and enthusiasts in the field of diabetes preach yoga, and often herbs, such as
Gymnema Sylvestre, which is sold by Beta Fast and claims to lower blood sugar
naturally. While many have reported successes with yoga and herbs, no FDA
results have been published.
A more controversial approach to
diabetes control or cure is stem-cell research. A recent report in The Edmonton
Sun stated that proposed legislation restricting the use of human embryonic
stem cells would not hamper efforts to find a cure for diabetes.
Dr. Gregory Korbutt, an
associate professor of surgery at the university's Surgical Medical Research
Institute plans to use human embryonic stem cells as part of his research.
He believes it could offer his
research team the best hope of finding a cure for diabetes and other diseases,
including Parkinson's. But he warned that getting hold of the cells in Canada
is already difficult and new legislation could further restrict research in
Canada.
While stem cell studies will
likely have no effect on current elderly diabetics, the research and new drugs
should help a future that will likely be crowded with elderly sufferers of the
disease.
Diet and Exercise
For current elderly diabetics,
diet and exercise are vital. Portion sizes need to be monitored and blood-sugar
levels constantly checked. Many new studies and diets, such as the Atkins Diet,
have shown that low-carbohydrate diets as opposed to low-fat diets are often
beneficial for diabetics and non-diabetics alike. Regardless, the medical
community seems to be united in the theory that portion sizes need to be kept
small and consistent for the best overall health.
As for exercise, there are many groups available at places lime
YMCAs and YWCAs that offer swimming and walking classes. Also, many elderly
people take advantage of local malls to provide a walk with plenty of places to
sit and interesting scenery. For elderly people who get almost no exercise,
anything is good. Walking to the mailbox, walking to the television to change
the channel, any movement you add to your day is a positive move, Leontos said.
“It’s a little bit of a paradigm
switch in how we treat older people with diabetes,” Leontos said.
“When we look at longevity,
medical research has concentrated a lot on how to keep people alive and have
done a pretty good job. I think we’re getting to the point where we are talking
about quality of life, so that we don’t have old sick people, we have old
healthy people,” she said.