2. What Is Type 2 Diabetes?

KEEPING TRACK OF BLOOD SUGAR LEVELS. In the short term, blood glucose levels that are either very high or very low can lead to serious medical problems, even emergencies. The person could become unconscious and go into a diabetic coma, called diabetic ketoacidosis, if his blood sugar numbers skyrocket. High blood sugar is known as hyperglycemia. On the other hand, if his numbers plummet to dangerously low levels, a condition called hypoglycemia, he can also lose consciousness.
In the long term, too much sugar in a person's blood can cause damage to nearly every major organ in the body. People with diabetes appear to be at increased risk for a host of other ailments, including Alzheimer's disease, dementia, heart disease, and stroke.
The complications of elevated blood sugar. Left unchecked, elevated blood glucose levels can lead to a number of damaging complications, including eye diseases such as retinopathy (which can lead to blindness), nephropathy (a disease of the kidneys that can lead to kidney failure), and nerve damage (or neuropathy), particularly of the legs and feet, which can lead to injuries, infections, and limb loss. Diabetes also affects other parts of the body's vascular system, increasing the risk of heart disease, stroke, and, in men, erectile dysfunction (impotence).

Specific concerns for older adults diagnosed with diabetes. Many older people with diabetes are asymptomatic -- meaning they have no symptoms -- and so they may remain undiagnosed until serious complications from the disorder arise. Even with a proper diagnosis, however, older adults with diabetes may face special challenges:

• Making lifestyle changes can be more difficult. Mobility issues, for example, may make exercising a challenge -- even though regular exercise is important for controlling blood sugar levels.

• Physical or financial restrictions can it more challenging for older adults to meet dietary requirements.

• Quitting smoking may be harder after more years of indulging in the habit.

• Even if someone with diabetes isn't particularly sedentary or overweight, his body's inability to respond to and use the insulin it produces -- a condition known as insulin resistance -- increases with age.

• Older folks are particularly susceptible to hypoglycemia, which can be triggered by medications -- including medications such as insulin that are designed to treat diabetes.

In addition, many older people have other medical conditions along with diabetes, and this can affect diabetes management. For example, if the person you're caring for has diabetes, hypertension, and high cholesterol, this combination is likely to speed up the progression of common vascular complications, such as kidney, eye, foot, heart, and blood vessel problems. And taking the medications required for such coexisting conditions can lead to adverse drug interactions, a common problem among seniors.

How to help someone who has diabetes. Despite all these challenges, there's a lot you can do to help an older adult manage diabetes:

• Learn all you can about the disease. The more you know, the more you can help. Take a diabetes education class with him and go to doctors' appointments together, if possible.

• Make sure he has the healthcare professionals he needs. See that he gets regular health checkups.

• Make healthy changes together. If you live with or near him, eat nutritious meals together. Encourage him to exercise by helping him find an active pastime he enjoys, or start exercising together.

• Learn to recognize signs of problems. You'll want to know what to look for when the person you're caring for has high or low blood sugar, as well as symptoms that may indicate a potential diabetes-related complication.

• Offer your compassion and support. It's not easy dealing with diabetes every day. You'll need to be kind, sympathetic, and understanding as he copes with the denial, anger, depression, and fear that often accompany a diabetes diagnosis.