One of the pathological mechanisms of Alzheimer’s disease involves impaired insulin signaling. The term “brain diabetes” or type 3 diabetes has even been coined to describe individuals who develop cognitive deficits after several decades of diabetes progression, explains geriatrician Judyta Samul-Jastrzębska in an interview with Medonet. Many seniors struggling with this condition regularly visit her office. Dr. Samul-Jastrzębska explains the complications associated with diabetes and how to manage it effectively.

The Growing Threat of Diabetes in Seniors

Diabetes can accelerate the development of heart diseases, atherosclerosis, chronic kidney failure, and dementia. Its prevalence increases with age. In Poland, 1 in 4 individuals over the age of 60 has been diagnosed with diabetes.

Maintaining a healthy lifestyle, incorporating physical activity, and adopting better eating habits are crucial for preventing and treating diabetes. The geriatrician shares practical advice on the changes seniors can implement immediately.

The Crucial Role of a Geriatrician

Geriatricians are specialists in the health of older adults, a group often affected by multiple chronic conditions that require tailored medical approaches. Seniors frequently struggle with declining health and independence, which can lead to anxiety. By providing empathy and understanding, geriatricians offer support and a sense of safety.

It is vital for seniors to feel heard and respected. Through personalized care, geriatricians not only help manage health problems but also advise on nutrition, physical activity, and mental well-being, aiming to preserve the highest possible quality of life.

The Link Between Diabetes and Cognitive Decline

A significant portion of senior patients suffers from cardio-metabolic diseases such as coronary artery disease, heart failure, hypertension, and type 2 diabetes. Diabetes accelerates heart disease, atherosclerosis, kidney failure, cognitive impairments, and dementia.

Insulin resistance, a hallmark of diabetes, also affects brain function. Impaired insulin signaling is one of the pathological mechanisms of Alzheimer’s disease. This has led to the emergence of the term “brain diabetes” or type 3 diabetes, often diagnosed in patients experiencing cognitive decline after decades of living with diabetes.

Diabetes Complications and Accelerated Aging

Diabetes can lead to severe complications, including:

• Polyneuropathy,
• Micro- and macroangiopathy,
• Diabetic foot syndrome,
• Limb amputations,
• Vision loss,
• Increased risk of infections.

Diabetes is a key factor in accelerating the aging process. “In short, the insulin and insulin-like growth factor pathway is one of the key regulators of cellular aging,” she explains. With age, the body’s beta cells in the pancreas weaken, insulin resistance increases, and pancreatic islet cells become less responsive to incretin hormones (GIP and GLP-1), which regulate blood glucose levels. Excess visceral fat and reduced muscle mass further contribute to the progression of diabetes.

Prevention and Lifestyle Changes

Despite these challenges, a healthy lifestyle remains the foundation for diabetes prevention. “Physical activity is one of the most effective ways to regulate carbohydrate metabolism and increase tissue sensitivity to insulin,”

Regular exercise helps maintain muscle mass and reduces the risk of obesity.

As the 16th-century physician Wojciech Oczko once said, “No medicine can replace movement.”

However, lifestyle changes alone may not be enough. Patients with diabetes often require pharmacotherapy. This must be paired with dietary modifications and physical activity adapted to the patient’s abilities. Dietary changes can be particularly challenging for seniors due to factors such as loss of appetite, lack of proper care, or financial limitations.

Tailoring Treatment for Older Patients

It is important to recognize that the treatment of diabetes in older patients differs from that of younger populations, with distinct goals for therapy.

This is especially true for the oldest seniors or those burdened with multiple comorbidities.

Special attention must be given to potential drug interactions, and insulin therapy, if necessary, should involve simple dosing regimens and easy-to-use injection devices.

The treatment must align with the patient’s psychosomatic state.

If cognitive impairments are suspected, caregivers must oversee medication administration.

“Diabetes remains one of the most significant epidemiological challenges among older adults. In Poland, 1 in 4 individuals over 60 has diabetes,”

Final Words

Addressing diabetes in the elderly requires a comprehensive approach that combines medical treatment, lifestyle modifications, and empathetic care. Through personalized guidance on nutrition, physical activity, and mental well-being, seniors can better manage their condition and maintain a higher quality of life for as long as possible.