Does Age Make Diabetes Harder to Control?
It seems that the older I get, the harder it is to control my diabetes and keep my A1C down. Right now, it is an unhealthy 9 percent. When I was younger, it used to be in the 7 range. Is it my age that is making my diabetes so hard to manage? Fiona Ansetta, Carson City, Nevada
Paris Roach, MD, responds
Several aspects of aging—moderate insulin resistance, less physical activity,weight gain, and certain illnesses and the medications they require—may be associated with higher blood glucose levels and increased medication requirements in people with diabetes.
What to Know
As people age, they may develop moderate insulin resistance, a situation in which the body doesn’t effectively use the insulin it produces. The beta cells in the pancreas usually make enough insulin to compensate, and the blood glucose stays normal. If the beta cells can’t fully compensate, diabetes may result.
Many people become less active as they age, and this can result in weight gain. Both physical inactivity and weight gain can contribute to higher glucose levels.
Finally, with aging comes an increased prevalence of illnesses such as inflammatory conditions, infections, and cancer, all of which may lead to an increase in blood glucose. A sustained rise in blood glucose levels may be the first sign of one of these conditions.
A number of medications can lead to higher glucose levels, the main offender being steroids (prednisone and similar drugs), which are often injected into joints and spinal areas to treat inflammation and arthritis. This can cause marked elevations in blood glucose.
Aging can be associated with increases in blood glucose and a need for more antidiabetic medication for a variety of reasons. Talk to your health care provider if you experience an unexplained and sustained increase in blood glucose so he or she can look for underlying causes.