Living with Type II Diabetes: Lifestyle Adjustments in the Elderly Type II diabetes, also known as non-insulin dependent diabetes (NIDDM), is a metabolic disorder that is primarily characterized by insulin resistance, relative insulin deficiency, and hyperglycemia. This is the most common type of diabetes that usually affects people over 40 years of age and is most common after age 55. Surveys say that there are over 13 to 14 million people in the United States who has diabetes and 90 to 95 percent of these suffer from type II diabetes. Studies show that eighty percent of people with type II diabetes are overweight. People who are slim and have type II diabetes usually have impaired insulin secretion. The majority of the people with type II diabetes do not need to be treated with insulin. Approximately twenty five percent are treated through diet and exercise programs alone.

Fifty percent of them with this type of diabetes are treated with oral medications called oral hypoglycemic agents which is used to lower blood sugar. In type II diabetes, either the body does not produce enough insulin or the cells ignore the insulin. In this condition, the pancreas either stops producing insulin or does not produce a reliable amount of hormone to regulate the body’s blood sugar.

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Insulin is necessary for the body to be able to use sugar in order to provide basic fuel for the cells.  When glucose accumulates in the blood instead of going into cells, the problem might that the cells may starve for energy and later on may run the risk of developing certain complications such as renal failure, kidney problem, eye disorder, wounds that fails to heal, coronary artery disease, diabetic retinopathy and peripheral neuropathy. Though complex as it seems, type II diabetes is not typically difficult to treat especially in the initial years when insulin is often still being produced by the pancreas. In this case, the person must also make specific measures of managing the factors that will directly affect his blood glucose levels and overall well being or else diabetes mellitus might become a life-long burden for him. Although there is no medical cure for diabetes yet, daily treatment helps control blood sugar, and may reduce the risk of complications. With a doctor’s help, diabetes type II can be managed by having proper balance of diet, engaging in exercise and taking certain prescribed medications. With these measures, it is rest assured that a diabetic person can still live a long, healthy and happy life—of course with better life management choices and proper medical assistance. Medical treatment for diabetes treatment can reduce symptoms, like thirst and weakness, and the chances of long-term problems, like heart and eye disease.

  If treatment with diet and exercise isn’t effective, a doctor may prescribe oral medications or insulin.  There is no known cure for diabetes; daily treatment must continue throughout a person’s lifetime While type II diabetes occurs at adult age, it is important that the person must be aware of how it might affect his life or his love ones. The diabetic himself therefore has to play an active role in managing certain situations to control or overcome its physical, emotional and psychological effects. AngerHaving type II diabetes could be a perfect reason to be angry with the world. At the moment one is diagnosed to be diabetic, anger may most likely to fire up with the question, “Why me?” or one may dwell on how unfair life is. One cause for anger to sprout out is that diabetes can make the afflicted person feel threatened.

Life for him may seem full of dangers: insulin reactions or sudden, irreversible complications. When the person fears these threats, anger often rushes to defense. And when anger develops, it is most likely to cause more harm than good—creating another problem aside from the diabetes itself. But well, diabetes experts articulate that anger can be properly controlled so that it can help the diabetic person protect himself.

 Anger worked against many diabetics. Take for example Babelina D., now 63, who was in her mid-forties diagnosed with type II diabetes. She was enraged that very instant. She perceived diabetes as a threat to her life and so to the lives of her whole family. She saw that this illness will make her unqualified to work and do church outreaches.

She didn’t want her congregation to know that she has this weakness since she has been known to be a woman of strength and strong will. With that, anger fueled her and leads her to deny diabetes. Denial is another problem to be discussed on the latter part of this paper.    The Anger CircleDiabetics who find themselves in anger circle like Babelina D.

don’t have to get stuck to it if there is a choice. In fact, there is really a choice—that is to simply break the circle. Dr. Weisinger’s Anger Work Out Book by Hendrei Weisinger, PhD. suggests three things. First, one must point out what makes him angry and take note of all those. Each evening he must think back over what happened the whole day and keep track of when he felt angry, what made him angry and who made him angry. After several weeks of observation, he must read the notes and see for any patterns.

Mary H., a woman in her mid-fifties was diagnosed with diabetes six months ago but, unlike Babelina, she was able to apply this method. When she read her anger diary, she learned that social situations made her angry. She did not like talking about diabetes in public. She felt angry when friends asked her what she could eat.

When she and her husband went out with friends, she felt her diabetes was the center of attention. Second, the diabetic person must change the thoughts, physical responses, and actions that fuel his anger. He must look for warning signs that his anger is building. Does he feel tensed? Does he talk louder and faster? When anger is taking over, one should be calm himself by taking a deep breath, talking slowly, getting a drink of water, sitting down, leaning back and quieting.

Actually, silence is the golden rule in these situations. But of course, this doesn’t mean that a person must stop being angry. Instead, this means that he should take charge and full control of his anger. Lastly, the person himself must find ways to make his anger work for him. The anger diary can help. Reading it over and over again may allow him to look at situations on how anger has helped him or harmed him. Slowly, this will able to help one realize what choice is better—that is to be angry or not? Actually, the goal of these steps is to make a diabetic person understand that anger is not solution.

Feeling of threats, being afraid, or frustrated are just normal responses. So anger must not last. Rather it must serve as a signal that one must have to take action to give proper him proper medical assistance. Hendrei Weisinger, PhD said in his book, “Anger can be a force for action, change and growth.

The better you understand your anger, the better you will be able to use it for good self-care.” DepressionStudies reveal that elders with diabetes have a greater risk of depression. The stress of daily diabetes management can build and may make one feel alone or set apart from friends and family because of all this extra work.  This therefore can get into a vicious cycle.

It can block good diabetes self-care and can consume much energy which will lead the diabetic to keep his good diet. He may loose appetite and of course, this will affect his blood sugar levels. What to do when depression gets in?The first step is to simply mark depression. Then next is to get help. If the person has really been so down-in-the-dumps because of his diabetes, then it’s time to talk to a doctor. Poor diabetes management is one cause of this.

During the day, high or low blood sugar may make the person feel tired or anxious. Low blood sugar levels can also lead to hunger and too much eating which will of course destruct a balanced diet plan. When the blood sugar is low at night the person may have difficulty sleeping. If the blood sugar is high, then he may get up often to urinate and then feel tired in the morning due to disturbed sleep pattern. DenialDenial is also a response for some diabetic adults.

It is their voice inside that keeps saying, “I can’t believe this. This is not true.”  It is most likely their response when they are first diagnosed with diabetes. They may think that something has gone out wrong with the doctor’s findings. In fact, the first reaction is not the problem. The trouble comes when the person keeps on denying his diabetes to such point that he also denies accepting medication or proper diet changes and self-management.

Thus, this will block him from learning what keeps him healthy. It will avoid him of self-care and shield him from the fact that diabetes is a lifelong, chronic illness which if left untreated will lead to complications. Denial will also make family members and friends to think that nothing is wrong. There is also a danger in asking a doctor who does not specialize in diabetes. The doctor may fuel the denial by telling the person that the diabetes case he has is mild and not serious enough to complicate. On the other hand, denial serves as a purpose.

It is a way for them to cope up with the bad news of diabetes. It can keep them from getting overwhelmed, angry or depressed. And it let them accept the fact little by little until they are ready. But it must be put to mind that when denial is prolonged it will disrupt health. American Diabetes Association (ADA) pointed out specific things that usually happens when the diabetic person indulge to denial. One, a person may give less important to checking blood glucose regularly and most likely to decide the he knows his blood glucose level by what he feels.

Doctors still encourage diabetics to use a meter in measuring blood glucose level than just by feelings as this will lead to accurate results. With that, he will know what proper measure of treatment to apply. Next is that a person may ignore meal plan changing and make wrong food choices. When this happens, diabetes will be harder to help. Another one is that he might forget that smoking is even more dangerous for him. He may reason out that smoking will keep him from eating too much.

Well, ADA strongly marked that smoking and diabetes is a deadly duo. Smoking increases the risk of complications and may contribute another problem. Fight back denial.Denial is humane. However, one must understand that it’s not helping at all times. Denial is bound to bring in from time to time. So when it does, it’s time to fight back.

Writing down diabetes care plan and health care goals will help and understanding why each item is important is essential. Accepting that it will take time to reach the goals will better give an assurance that everything is under control. When one finds out that he has been denying some of the diabetes health care, then asking a diabetes specialist will be helpful. If the food plan is the problem, then he must seek advice from a registered dietitian and together they can come up with a solution. Telling the family members and friends about the real situation will do a lot to help the person with diabetes to cope up.

Informing them about diabetes health care will also make them want to adopt healthy habits. Managing type II diabetes means making some changes to how an elderly must live. Talking with doctors specializing in diabetes health care is the best way to get help. Aside from that, personal decision to undergo specific lifestyle changes is even so important: following healthy, balanced diet, lose weight if the doctor prescribed, being more active, testing blood sugar regularly, having the doctor check the A1c (the average blood sugar over the past two to three months), taking the prescribed medicines and quit smoking. As it has been said earlier, type II diabetes will not hinder one from achieving a fuller life if proper measures and actions are made.            References: Taking Control of Your Diabetes, 1997-2007 GlaxoSmithKline.

from the World Wide Web: American Diabetes Association (ADA). Retrieved April 28, 2007 from the World Wide Web:

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Am Fam Physician . 2001 Mar 15;63(6):1159-63, 1165-6. Larson PR, Kronenberg HM, Melmed S, et al. Williams Textbook of Endocrinology . 10th ed.

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