diabetes in older adults

Overview

Diabetes is a condition that causes too much sugar to stay in your blood. Sugar comes from the food you eat, and a hormone called insulin normally helps move sugar into your cells to be used for energy. In older adults, diabetes most often means type 2 diabetes, where the body does not use insulin well or does not make enough of it. Over time, high blood sugar can damage blood vessels, nerves, and organs. But with the right care, many people live well with diabetes for many years.

Yes. Diabetes becomes more common as people get older. Millions of adults over 60 live with diabetes, and many more have blood sugar levels that are higher than normal but not yet diabetes — a condition called prediabetes.

Diabetes can affect anyone, but it becomes more common with age. Older adults who are overweight, have a family history of diabetes, have high blood pressure, or are less physically active are at higher risk. People from certain ethnic backgrounds also have a higher risk of type 2 diabetes.

Symptoms

Common symptoms

• Feeling very thirsty and drinking more than usual
• Urinating more often, especially waking up at night to urinate
• Feeling very tired or weak
• Blurred vision
• Slow healing of cuts and bruises
• Tingling, numbness, or pain in the hands and feet

Symptoms in children

• Diabetes in children is not the same as diabetes in older adults and requires different care. Symptoms in a child may include bedwetting, significant weight loss, unusual thirst, extreme tiredness, frequent urination, and signs of dehydration. If you are worried about a child, call a doctor promptly.

Symptoms in older adults

• Confusion or memory problems
• Feeling dizzy or light-headed, which can lead to falls
• Urinary incontinence or more frequent infections
• Extra tiredness or weakness
• Unexplained weight loss or poor appetite
• Blurred vision or eye discomfort
• Numbness or tingling in the feet

Causes

Main causes

• The body stops responding well to insulin, a hormone that helps sugar enter cells; this is called insulin resistance.
• The pancreas does not make enough insulin to keep blood sugar normal.
• Over time, high blood sugar builds up in the blood because it cannot get into the cells properly.

Risk factors

• Age over 60
• Being overweight or having extra fat around the waist
• A family history of diabetes
• High blood pressure or high cholesterol
• Being physically inactive
• History of gestational diabetes during pregnancy (if female)
• Being from a South Asian, African-Caribbean, Middle Eastern, or other high-risk ethnic background
• Long-term use of some medicines, such as steroids

When to see a doctor

See a doctor urgently if:

• If you feel confused, very drowsy, or have difficulty breathing
• If your blood sugar is very high or very low and you feel unwell
• If you have signs of a serious infection, such as high fever, shaking, or a wound that is not healing
• If you have chest pain, severe abdominal pain, or any sudden weakness

Book a routine appointment if:

• If you are over 40 and have not had your blood sugar checked
• If you have symptoms like increased thirst, frequent urination, fatigue, blurred vision, or slow healing
• If you have been told you have prediabetes or high blood sugar
• If you have diabetes and need a regular check-up or medication review

Diagnosis

Diabetes is diagnosed with a blood test that measures your blood sugar level. It usually requires at least one blood sample, and sometimes a second test on another day to confirm.

Tests that may be done

• Fasting blood sugar test — checks your blood sugar after you have not eaten for at least 8 hours.
• HbA1c blood test — shows your average blood sugar level over the past 2 to 3 months.
• Oral glucose tolerance test — checks how your body handles a sugary drink over a few hours.
• Random blood sugar test — a non-fasting blood sample that can be done at any time.

What to expect at your appointment

If your test result is normal, your healthcare provider will tell you what to do to keep it that way. If it shows diabetes, your provider will explain what the numbers mean and talk with you about safe next steps. They may check your blood pressure, cholesterol, feet, eyes, and kidney function at the same visit or soon after. You will not need to make all decisions at once. A diabetes care team can guide you.

Treatment

There is no cure for diabetes yet, but it can be managed very well. The goal of treatment is to keep blood sugar in a safe range and to protect your heart, kidneys, eyes, and nerves. Treatment is tailored to each person, and your age, overall health, and lifestyle all matter. What works for one person may not be right for another.

Self-care at home

• Check your blood sugar as often as your care team recommends.
• Take all prescribed medicines exactly as directed — do not stop or change them without talking to your doctor.
• Wear comfortable shoes and check your feet daily for cuts, blisters, or redness.
• Keep fluid handy and drink enough water, especially if you are sick.
• Carry a note or medical ID that says you have diabetes.
• Stay active safely — even short walks after meals can help balance blood sugar.

Medical treatments

Healthcare providers may start with lifestyle changes, such as a balanced diet and regular physical activity. If that is not enough, they may prescribe tablets or other medicines that help lower blood sugar. Some people need injectable medicines, including treatments that replace or act like insulin. The choice depends on your type of diabetes, your other health conditions, and your personal needs. Your care team will explain each medicine, how to use it, what side effects to watch for, and what to do if you miss a dose. Never take any diabetes medicine that was not prescribed for you.

When is surgery considered?

Surgery is not a standard treatment for diabetes itself. However, some older adults with type 2 diabetes and severe obesity may be considered for weight-loss surgery (also called bariatric surgery) as part of their overall care. This is only considered after a full assessment by specialists and is not right for everyone.

Living with this condition

Living with diabetes means building a gentle daily routine. You will likely check your blood sugar, eat balanced meals, take your medicines, and stay active. It can feel overwhelming at first, but you do not need to be perfect. Small daily choices — like drinking water instead of sugary drinks and taking a short walk — add up. Your diabetes team will help you learn what works for you and review your plan regularly.

Lifestyle tips

• Aim for regular physical activity, such as walking, swimming, chair exercises, or gardening, according to what is safe for you.
• Eat regular meals with a balance of vegetables, whole grains, lean protein, and healthy fats.
• Limit sugary drinks, sweets, and highly processed foods.
• Get enough sleep and try to manage stress with breathing exercises, hobbies, or talking to someone you trust.
• If you smoke, talk to your healthcare provider about support to quit.
• Limit alcohol, and never drink on an empty stomach if you take diabetes medicines.

Diet and exercise

You do not need a special 'diabetic diet'. A healthy plate usually means filling half your plate with vegetables, a quarter with protein like fish or beans, and a quarter with whole-grain foods like brown rice or wholewheat bread. Eating at regular times helps prevent blood sugar swings. For exercise, walking is excellent and free. If your mobility is limited, ask a physiotherapist or diabetes educator for seated exercises that are safe for you. Always talk to your doctor before starting a vigorous exercise programme.

Mental health and emotional wellbeing

Living with a long-term condition can be emotionally draining. It is normal to feel worried, frustrated, sad, or burned out at times. Your feelings are just as important as your blood sugar numbers. Talking to your care team, family, or a counsellor can help. If you ever feel hopeless, badly depressed, or have thoughts of harming yourself, please reach out for help immediately. You matter, and support is available.

Prevention

You cannot always prevent diabetes, especially if you have a strong family history. But in many cases, type 2 diabetes can be delayed or prevented, even in later life. The key is maintaining a healthy body weight, eating balanced meals, staying physically active, and keeping blood pressure and cholesterol within a healthy range. Even modest changes, like walking after meals and cutting out sugary drinks, can make a real difference.

Vaccines

People with diabetes are at higher risk of infections, so vaccines are important. Talk to your doctor or pharmacist about recommended vaccines, including flu, pneumonia, COVID-19, and hepatitis B. Stay up to date with your routine immunisations, and carry a note of when you last had them.

Screening programmes

If you have prediabetes or risk factors for diabetes, your healthcare provider may recommend a blood test every year or so. Regular check-ups allow you to catch changes early. If you already have diabetes, screening for eye, kidney, and foot problems is a standard part of your care. Ask your team to explain your screening schedule.

Complications

If left untreated

• Over time, high blood sugar can damage blood vessels, leading to heart disease, stroke, and kidney disease.
• Nerve damage can cause pain, numbness, and weakness in the feet and hands, and may lead to serious foot problems.
• Eye problems, including diabetic retinopathy, can cause sight loss if not monitored.
• Poor circulation and slower healing can turn small cuts into serious wounds.
• Diabetes increases the risk of infections, including urinary, skin, and gum infections.

Long-term outlook

A diagnosis of diabetes in later life can feel deeply unfair and worrying, but it is not a sentence of suffering. Many older adults live full, active, and healthy lives with diabetes. The most important thing is not to aim for perfection, but to stay engaged with your care, find support, and make small improvements that feel doable. With good management, today's treatments and programmes can help you protect your health and enjoy your years. Every step you take toward your well-being matters.

Find support

Local organisations

• Diabetes UK ↗ · United Kingdom

Helplines

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