By Ka Hei Karen Lau and Dr. Zhiheng Henry He
In the United States, over 25 percent of the population is 65 years of age or older. Unfortunately, the risk of developing diabetes is significantly increased in this particular population. Other factors that may contribute to this increased risk include having Asian ancestry, being overweight, having a family history of diabetes or a history of gestational diabetes or prediabetes.
Diabetes is a condition in which the body cannot properly handle nutrients from food, which eventually leads to elevated blood glucose. Type 2 diabetes is the most common type of diabetes among Asian Americans, especially seniors. It can be prevented or delayed by eating healthy and staying active. If you have been diagnosed with diabetes, you will also benefit from this healthy lifestyle, which will help to better control your blood glucose and prevent diabetes complications, such as heart disease, loss of vision, kidney failure or loss of limbs.
A healthy meal plan for people with or at risk of diabetes is not much different from a healthy meal plan for the general population. A healthy diet should provide your daily nutrient needs and also help you manage your blood glucose levels. When planning your meals, follow a ratio of 2:1:1 – for every two servings of non-starchy vegetables (e.g. leafy greens), have one serving of grain products or other starches (e.g. pumpkin), and one serving of protein (e.g. fish and chicken).
As you get older, your caloric needs decrease, and sometimes, your appetite decreases as well. It is important to choose food with high nutritional value but low caloric density to meet your needs without gaining unneeded extra weight. Try to include vegetables of different colors (green, purple, red, yellow and white), whole grains (e.g. brown rice) and lean protein (e.g. tofu, skinless/low-fat chicken or meat and fish) at each meal. Also try to limit the use of processed food and condiments to help lower your sodium intake. This will help you better control your blood pressure, which often increases as you age and is a complication of diabetes.
Like healthy eating, exercise is crucial to diabetes management and prevention as well as to overall health. Exercise helps lower blood glucose. Try to do aerobic exercises for 150 minutes at a moderate intensity each week, such as walking faster than your usual pace, or doing some higher intensity chores. If possible, also include 15 minutes of exercise after each meal to prevent the post-meal blood glucose surge. Doing muscle-strengthening exercises twice a week, such as carrying your groceries in a basket instead of using a cart, is a good way to improve strength, fitness and blood glucose control. In addition, include exercises that improve your balance and coordination, such as tai chi or dancing. These will help in preventing falls, which cause severe injuries among seniors.
If you have been prescribed medications, follow the regimen as prescribed. If you have concerns about your medications, call your doctor’s office; do not stop or adjust the medication without talking to your doctor. Always bring all your drugs, herbal medications, supplements, glucose meter, and blood glucose records to all your doctor’s appointments. These provide essential information for your health care team to understand your condition better and provide you with better overall care.
Everyone is unique, and so each effective regimen to bring diabetes under control is highly individualized. This is especially important for seniors. Diabetes in seniors tends to have other co-existing health issues, such as heart disease, poor eyesight, limited mobility, impaired memory, being frail and having low sugar. Overly rigid control over diet may increase the chance of low sugar and can actually hurt one’s health. Therefore, it is critical to establish a personalized blood glucose goal, meal plan and exercise regimen with your doctor, registered dietitian and exercise physiologist for the care plan that fits your needs.
Ka Hei Karen Lau is a registered dietitian and certified diabetes educator in the Asian Clinic at Joslin Diabetes Center; Dr. Zhiheng Henry He is an endocrinologist in the Asian Clinic at Joslin Diabetes Center.
This post is also available in: Chinese