Content Sources:
1. World Health Organization. "Criteria for the diagnosis and classification of diabetes." Year 2006.
2. American Diabetes Association. "Diagnostic criteria for type 2 diabetes." 2021 Clinical Practice Guidelines.
3. Chinese Diabetes Society. "Guidelines for the prevention and treatment of type 2 diabetes in China." Year 2020.
Geriatric diabetes is a health problem that has attracted much attention, and diabetes, as an "immortal cancer", plagues many people, including the elderly. In 2018, 72-year-old Uncle Li, who lives in Hubei, was diagnosed with diabetes.
At first, when the body showed a series of symptoms, Uncle Li didn't notice it, thinking that it was a geriatric disease caused by old age, but later he found that his vision was getting more and more blurry, and people were always tired and weak, so he reflected that there was something wrong with his body.
After a systematic examination by the hospital, my fasting blood sugar was 10.2mmol/L, and I learned that I was suffering from diabetes.
Diabetes mellitus is a chronic metabolic disease characterized by hyperglycemia. As the number of people living with diabetes continues to increase worldwide, it is important to understand and identify their diagnostic criteria. The diagnosis of diabetes mellitus is mainly based on several indicators, including fasting blood glucose level, 2-hour postprandial blood glucose level, glycosylated hemoglobin, etc.
According to the latest standards of the World Health Organization and the American Diabetes Association, fasting blood glucose values are used in the diagnosis of diabetes mellitus as follows: fasting blood glucose level less than 5.6 mmol/L is considered normal; 5.6 to 6.9 mmol/L indicates impaired fasting blood glucose;
Diabetes mellitus is diagnosed when the fasting blood glucose level reaches or exceeds 7.0 mmol/L. It is important to ensure the accuracy of the diagnosis, at least two tests need to be performed on different days to confirm.
It is also important to understand the conditions under which fasting blood glucose values are measured, i.e., no food should be consumed for at least 8 hours before the test, and only unsweetened water should be consumed. This is because the intake of food can affect blood sugar levels, which can interfere with the diagnosis.
The measurement and monitoring of fasting blood glucose is of great significance for the prevention and management of diabetes. Individuals with impaired fasting blood glucose, although not yet classified as diabetic, are at very high risk and need to make lifestyle changes, such as increasing physical activity and adjusting dietary habits, to reduce the risk of developing diabetes.
In addition, although fasting blood glucose level is an important diagnostic tool, it can also be affected by a variety of factors in practice, such as measurement time, accuracy of the instrument, and personal physiological state. Therefore, when determining the diagnosis of diabetes, doctors usually combine other indicators and clinical manifestations to make a comprehensive evaluation.
For Uncle Zhang, the next thing to do is to control the development of blood sugar and ensure that it is in a relatively stable range. But this made him a little difficult, for their elderly blood sugar control to what extent is it considered to be the standard?
The standard of glycemic control in elderly patients with diabetes is slightly different from that of adults, and the standard of glycemic control is also relatively lenient considering the diversity of physical conditions and sensitivity to hypoglycemia in the elderly.
1. Blood sugar control standards for elderly patients with diabetes
Criteria for glycemic control in older patients with diabetes differ from those in younger patients. According to the guidelines of the Chinese Diabetes Society and the recommendations of the International Diabetes Federation, glycemic control goals for elderly patients with diabetes should be individualized according to the specific situation of the patient. In general, the following criteria are recommended glycemic control goals for most older patients with diabetes:
Fasting blood glucose: It is recommended to control it at 5.0-7.2 mmol/; 2-hour postprandial blood glucose: It is recommended to control it at <10 mmol/L; Glycosylated hemoglobin (HbA1c): It is recommended that the target be set according to the specific situation of the patient, and the HbA1c target can be appropriately relaxed to 8% for elderly patients with multiple chronic diseases, functional limitations, or short life expectancy.
For older people with diabetes, tight blood sugar control can reduce the risk of chronic complications, such as cardiovascular disease, nephropathy, retinopathy, neuropathy, etc. Diabetes is a chronic disease, and a long-term state of high blood sugar can cause damage to various organs in the body. In addition, due to the natural aging of the body, the body is less able to recover from disease and adapt to the disease in older patients than younger people, so it is important to control blood sugar.
2. How to achieve blood sugar control goals
For elderly people with diabetes, proper blood sugar control is the key to prolonging life and improving quality of life. First of all, the physiological functions of older people are lower than those of younger people, including decreased insulin secretion, increased insulin resistance, and decreased kidney function, so more cautious and individualized blood glucose control is required.
1. Monitor blood glucose: For elderly diabetic patients, it is recommended to monitor blood glucose levels regularly and adjust the treatment plan according to the results of self-monitoring blood sugar and the doctor's recommendations.
2. Dietary management: Dietary management in elderly patients with diabetes is the cornerstone of blood sugar control. It is recommended to adopt a low-sugar, low-fat, high-fiber diet, avoid high-sugar and high-fat foods, and eat more vegetables, whole grains, legumes, etc. Older people often have varying degrees of chewing difficulties and digestive and absorption problems, so the texture of food should also be appropriately selected, both to ensure nutrition and easy to digest.
3. Medication: For elderly patients with diabetes, doctors will formulate a drug treatment plan according to the specific situation of the patient. When choosing a drug, the hypoglycemic effect of the drug, its effect on body weight, the risk of hypoglycemia, and the patient's renal function status are usually taken into account.
For most older people with diabetes, insulin remains one of the safer and more effective treatment options. However, older people should take special care to avoid hypoglycemia when taking insulin.
4. Moderate exercise: Moderate exercise can help control blood sugar, lose weight, and improve insulin sensitivity. For older diabetic patients, suitable forms of exercise include light to moderate intensity activities such as walking, yoga, and tai chi. Before starting a new exercise program, it is recommended to consult a doctor to develop a reasonable exercise plan according to your health condition to avoid the risks caused by excessive exercise.
5. Weight control: Weight gain can increase insulin resistance, which is not good for blood sugar control. Maintaining a healthy weight through diet management and moderate exercise is essential for blood sugar control.
In conclusion, glycemic control in elderly patients with diabetes requires individualized treatment goals according to the specific situation of the patient, reasonable arrangement of diet, exercise and medication, regular blood glucose monitoring, and close attention to the challenges that the patient may encounter in the process of disease management. Through close cooperation between doctors and patients, blood sugar can be effectively controlled, complications can be reduced, and the quality of life of elderly diabetic patients can be improved.