Diabetes is characterized by high blood glucose levels and is the most common age-related disorder of the endocrine system. Diabetes is found in an estimated 10% of people between the ages of 56 and 64, 20% in those ages 65 to 74, and 40% in those over the age of 85. Approximately 24 million people in the US have this disorder.
There are two major types of diabetes. Type 1 diabetes, also known as juvenile diabetes, occurs in 5 to 10% of cases. The pancreas produces little or no insulin, which is needed to allow cells to take up glucose. There is no known cause of the disorder, but some researchers have hypothesized that it could be genetic. Other research suggests that it could be due to exposure to certain viruses. Nonetheless, this type of diabetes is thought to be an auto-immune disorder that is insulin-dependent.
Type 2 diabetes, also known as adult-onset diabetes, occurs in about 90% of cases. Unlike those with type 1 diabetes, people with type 2 diabetes are not insulin dependent. However, the insulin their pancreas secretes is either not enough or the body is unable to recognize the insulin and use it properly. This is called insulin-resistance. When there isn’t enough insulin, or the insulin is not used as it should be, the glucose (sugar) is unable to enter the body’s cells. When glucose builds up in the blood, instead of going into the cells, the cells of the body are not able to function properly. Increased urination to clear glucose from the body can lead to dehydration, which can cause a diabetic coma. Over time, the high glucose levels in the blood may damage the nerves and small blood vessels of the eyes, kidneys, and heart. Furthermore, high glucose levels can predispose a person to atherosclerosis (hardening) of the large arteries that can cause heart attack and stroke. Type 2 diabetes has strong genetic factors and tends to run in families. It also has a strong association with obesity—research has found that insulin resistance is related to a history of high glucose meals.
Diabetes has many associated complications. Many of these are age-related diseases, leading some to suggest that diabetes is a progeroid (an accelerated aging syndrome). Complications include cataracts, arteriosclerosis, peripheral neuropathy, diabetic retinopathy, and nephropathy.
One of the primary treatment options for diabetes is in the form of prevention. This includes reducing obesity and increasing physical activity. The incidence of type 2 diabetes is closely tied to body fat. Maintaining a healthy diet low in fat and avoiding excessive intake of carbohydrates can contribute to decreasing body fat. Physical activity reduces obesity, as well. It is associated with increased glucose tolerance and insulin sensitivity, both of which are diminished in diabetes. Treatment options include lifestyle changes to maintain a healthy body weight, pharmaceutical intervention, and surgical intervention.
Older adults are often vulnerable to this disorder. Elderly people in nursing homes and assisted living facilities, such as those in La Puenta and La Verne, California, must be given the proper care and nutrition, as well as be encouraged to engage in appropriate forms of physical activity, to combat diabetes and maintain a healthy weight.