Type 2 diabetes living in older adults

Overview

Type 2 diabetes is a long-term condition where your body does not use insulin properly, leading to high blood sugar levels. Insulin is a hormone that helps sugar from food get into your cells for energy. Over time, high blood sugar can damage organs and blood vessels.

Yes, type 2 diabetes is very common, especially in people over 45. Almost one in four adults over 65 has diabetes, and most have type 2.

It affects older adults, but can also occur in younger people. Risk increases with age, being overweight, having a family history, or being from certain ethnic backgrounds (e.g., South Asian, African-Caribbean).

Symptoms

Common symptoms

• Feeling very thirsty often
• Urinating more than usual, especially at night
• Feeling very tired
• Blurred vision
• Cuts or wounds that heal slowly
• Numbness or tingling in hands or feet
• Unexplained weight loss

Symptoms in children

• Type 2 diabetes in children is less common; symptoms are similar to adults but may be missed because children often have no symptoms initially.

Symptoms in older adults

• Older adults may not have the typical symptoms. Instead, they might feel unusually tired, confused, have frequent infections (like urinary tract or skin infections), or notice a sudden change in vision.
• They may also have increased falls, incontinence, or slow recovery from illness.

Causes

Main causes

• Your body’s cells become resistant to insulin, so sugar cannot enter them properly.
• Your pancreas cannot produce enough insulin to keep up with demand.

Risk factors

• Being overweight, especially carrying weight around your waist
• Having a family history of diabetes
• Being over 45 years old
• Being physically inactive
• Having high blood pressure or high cholesterol
• Having had gestational diabetes (diabetes during pregnancy)
• Ethnicity – Black African, African-Caribbean, South Asian, and Chinese backgrounds have higher risk

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above
• If your blood sugar stays above 16.7 mmol/L despite taking your usual medication

Book a routine appointment if:

• If you notice new or worsening symptoms like thirst, frequent urination, or tiredness
• For regular diabetes check-ups (usually every 3 to 6 months)
• If you are due for eye, kidney, or foot exams

Diagnosis

A simple blood test measures your blood sugar level. Your doctor may also do an A1c test, which shows your average blood sugar over the past 2 to 3 months.

Tests that may be done

• Fasting blood sugar test (after not eating for 8 hours)
• A1c test (HbA1c)
• Oral glucose tolerance test (drinking a sugary drink and measuring blood sugar afterwards)

What to expect at your appointment

The tests are quick and simple. Your doctor will explain your results and what they mean. If diagnosed, you will be referred to a diabetes education program and start a plan for healthy eating, activity, and perhaps medication.

Treatment

Treatment focuses on keeping blood sugar levels in a healthy range. This usually involves lifestyle changes and may include medication or insulin. The goal is to prevent complications and maintain quality of life.

Self-care at home

• Follow a healthy eating plan – eat more vegetables, whole grains, and lean protein, and cut back on sugary drinks and processed foods.
• Be physically active – aim for at least 150 minutes of moderate exercise per week (walking, swimming, cycling).
• Monitor your blood sugar regularly as advised by your doctor.
• Take your medication exactly as prescribed.
• Check your feet daily for cuts, blisters, or swelling.
• Keep a healthy weight.

Medical treatments

Doctors may prescribe metformin (a common first-line drug) to help your body use insulin better. Other medicines can increase insulin production or help your kidneys remove extra sugar. Some people need insulin injections. Your doctor will choose what is safest for you based on your age, kidney function, and other health conditions. Never change your dose without medical advice.

When is surgery considered?

Surgery is not a standard treatment for type 2 diabetes, but bariatric surgery (weight loss surgery) may be an option for some people with severe obesity and diabetes. It can improve blood sugar control. This is decided on an individual basis.

Living with this condition

Living with diabetes means paying attention to what you eat and how active you are, checking your blood sugar, and taking medications. Many people get into a comfortable routine. It is important to keep all medical appointments and ask for help when you need it.

Lifestyle tips

• Eat meals at regular times to keep blood sugar steady.
• Avoid sugary drinks and limit alcohol.
• Stay active every day – even short walks help.
• Get enough sleep (7-8 hours a night).
• Manage stress – try relaxation techniques or talk to someone.

Diet and exercise

A balanced diet with plenty of vegetables, whole grains, and lean protein (like fish or chicken) can help control blood sugar. Avoid large portions of starchy foods. Exercise lowers blood sugar and improves insulin sensitivity. Start slowly and increase gradually. Talk to your doctor before starting a new exercise program.

Mental health and emotional wellbeing

Living with a chronic condition can be stressful. It is common to feel worried, frustrated, or depressed. Mental health matters just as much as physical health. Reach out to your healthcare team, a counselor, or a support group. You are not alone.

Prevention

Type 2 diabetes cannot always be prevented, but you can lower your risk by maintaining a healthy weight, being active, eating a balanced diet, and avoiding smoking. For people with prediabetes, these steps can sometimes reverse the condition.

Vaccines

It is important to stay up to date with vaccines, especially the flu vaccine, pneumonia vaccine, and COVID-19 vaccine, because diabetes can weaken your immune system.

Screening programmes

If you are 45 or older, or have risk factors, ask your doctor about a blood sugar test. Early detection helps prevent complications.

Complications

If left untreated

• Heart disease and stroke
• Kidney disease that may lead to dialysis
• Nerve damage causing pain, numbness, or foot ulcers
• Vision problems and blindness (diabetic retinopathy)
• Slow wound healing and increased risk of infections
• Damage to blood vessels in the legs (peripheral artery disease)

Long-term outlook

With good management, most people with type 2 diabetes can live long, active lives. Keeping blood sugar, blood pressure, and cholesterol under control greatly reduces the risk of complications. Your healthcare team will help you stay on track.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.