Nearly 1 in 4 adults over 65 has diabetes—about 15 million people. If your aging parent has diabetes, you play a critical role in helping them manage it, especially as age-related challenges like cognitive decline, vision problems, and dexterity issues make self-management harder.
Understanding Blood Sugar Targets
Blood sugar management in elderly adults is often less aggressive than in younger people. Too-tight control increases the risk of dangerous hypoglycemia (low blood sugar), which can cause falls, confusion, and even death in seniors.
| Measurement | Healthy Senior Target | Frail/Complex Senior |
|---|---|---|
| Fasting blood sugar | 90-130 mg/dL | 100-180 mg/dL |
| Before meals | 90-130 mg/dL | 100-180 mg/dL |
| 2 hours after meals | Under 180 mg/dL | Under 200 mg/dL |
| A1C (3-month average) | 7.0-7.5% | 7.5-8.5% |
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Recommended Diabetes Care Products
- Glucose Meter Kit with Test Strips Easy-to-read display with large numbers for accurate monitoring
- Glucose Tablets for Low Blood Sugar Fast-acting treatment for hypoglycemia episodes
- Diabetic Compression Socks Non-binding socks that promote circulation and protect sensitive feet
- Automatic Pill Dispenser with Alarm Ensures diabetes medications are taken on schedule
Recognizing Blood Sugar Problems
Low Blood Sugar (Hypoglycemia)
Below 70 mg/dL – Can be life-threatening
- Shakiness, trembling
- Sweating, clamminess
- Confusion, irritability
- Dizziness, lightheadedness
- Hunger
- Fast heartbeat
- Headache
- Seizures (severe)
High Blood Sugar (Hyperglycemia)
Above 180 mg/dL – Causes long-term damage
- Frequent urination
- Excessive thirst
- Blurred vision
- Fatigue
- Headache
- Slow-healing wounds
- Fruity breath odor
- Nausea (severe)
Treating Low Blood Sugar
Follow the "Rule of 15":
Give 15 grams of fast-acting carbs
4 glucose tablets, 4 oz juice or regular soda, 1 tablespoon honey or sugar, or glucose gel
Wait 15 minutes
Recheck blood sugar after 15 minutes
Repeat if still low
If still under 70, give another 15 grams and wait 15 more minutes
Follow with a snack
Once blood sugar is above 70, eat a small snack with protein if next meal is more than an hour away
Diabetes Medications
Understanding your parent's diabetes medications helps you support proper management and watch for side effects:
Metformin (Glucophage)
Usually the first medication prescribed for Type 2 diabetes.
- Take with food to reduce stomach upset
- Low risk of hypoglycemia when used alone
- May need to stop before medical procedures with contrast dye
- Watch for B12 deficiency with long-term use
Sulfonylureas (Glipizide, Glyburide)
Older class of diabetes medications, still commonly used.
- Higher risk of hypoglycemia – especially in elderly
- Take 30 minutes before meals
- Don't skip meals after taking
- May cause weight gain
SGLT2 Inhibitors (Jardiance, Farxiga)
Newer medications with heart and kidney benefits.
- Take in the morning (increases urination)
- Increases UTI and yeast infection risk
- May cause dehydration in seniors
- Heart and kidney protective effects
GLP-1 Receptor Agonists (Ozempic, Trulicity)
Weekly injections that help with blood sugar and weight.
- Low risk of hypoglycemia
- May cause nausea, especially when starting
- Promotes weight loss
- Heart protective benefits
Insulin
May be needed as Type 2 diabetes progresses.
- Risk of hypoglycemia – especially with long-acting insulins
- Proper storage (refrigerate unopened, room temp once open)
- Rotate injection sites
- Basal (long-acting) vs. bolus (mealtime) dosing
- Some seniors do well on once-daily long-acting insulin only
Blood Sugar Monitoring
Regular monitoring is essential, but the frequency depends on your parent's medications and stability:
Traditional Finger-Stick Monitors
- Most affordable option
- Test strips can be expensive
- Requires dexterity and vision
- Provides a snapshot in time
- May need help if hands are arthritic
Continuous Glucose Monitors (CGMs)
- Sensor worn on arm or abdomen
- Readings every 5 minutes
- Shows trends and patterns
- Alerts for highs and lows
- Can share data with caregivers
- Medicare covers with certain criteria
Diet and Nutrition
A diabetes-friendly diet doesn't have to be restrictive. Focus on balance and consistency:
✓ Emphasize
- Non-starchy vegetables
- Lean proteins
- Whole grains (in moderation)
- Healthy fats (olive oil, nuts)
- Berries, cherries
- Beans, legumes
⚠ Limit
- White bread, rice, pasta
- Potatoes
- Fruit juice
- Processed meats
- Fried foods
- Alcohol
✗ Avoid/Minimize
- Sugary drinks (soda, sweet tea)
- Candy, desserts
- Pastries, donuts
- Sweetened cereals
- High-sugar condiments
Practical Eating Tips for Seniors
Consistent meal timing
Eating at regular times helps stabilize blood sugar, especially for those on insulin or sulfonylureas.
Don't skip meals
Skipping meals while taking diabetes medication can cause dangerous hypoglycemia.
Pair carbs with protein
Adding protein to carbohydrates slows sugar absorption and prevents spikes.
Stay hydrated
High blood sugar causes dehydration. Encourage water throughout the day.
Read nutrition labels
Focus on total carbohydrates, not just sugar. Carbs from any source affect blood sugar.
Preventing Complications
Diabetes damages blood vessels over time, affecting nearly every organ system. Regular screening and prevention are crucial:
Eye Disease (Retinopathy)
Leading cause of blindness in adults. Annual dilated eye exams are essential. Early treatment can prevent vision loss.
Foot Problems
Nerve damage and poor circulation can lead to ulcers and amputation. Check feet daily for cuts, blisters, or color changes. See a podiatrist regularly.
Heart Disease
People with diabetes are 2-4x more likely to have heart disease. Control blood pressure, cholesterol, and blood sugar. Most should be on a statin.
Kidney Disease (Nephropathy)
Diabetes is the #1 cause of kidney failure. Annual urine test for protein and blood tests for kidney function. SGLT2 inhibitors offer protection.
Dental Problems
Higher risk of gum disease and infections. Regular dental visits are important. Poor dental health can make blood sugar harder to control.
Daily Foot Care
Foot problems are one of the most preventable—and most serious—diabetes complications. Establish a daily routine:
Inspect feet daily
Look for cuts, blisters, redness, swelling, or nail problems. Use a mirror for the bottom or have someone help.
Wash and dry carefully
Wash feet daily in lukewarm water. Dry thoroughly, especially between toes where infections start.
Moisturize (but not between toes)
Apply lotion to prevent cracking, but not between toes where it can promote fungal infections.
Wear proper footwear
Never go barefoot. Wear well-fitting shoes and seamless socks. Medicare covers diabetic shoes.
See a podiatrist
Regular foot exams and professional nail care, especially if nails are thick or vision is poor.
Track Blood Sugar & Medications
Our daily care logs include medication tracking, blood sugar logs, and symptom monitoring all in one place.
Get the Care Coordination BinderWhen to Call the Doctor
- Blood sugar below 70 that doesn't respond to treatment
- Blood sugar above 300 mg/dL, especially with symptoms
- Signs of ketoacidosis: nausea, vomiting, abdominal pain, fruity breath
- Confusion or altered consciousness
- Foot wounds, even small ones that don't heal
- Signs of infection (fever, redness, swelling)