Insulin and medications are an important part of diabetes management. But if you are an older adult with diabetes, particularly if you have mental or physical limitations, managing medications and insulin can present some unique challenges.
“It’s a common medical problem we see in seniors with diabetes,” said Karen Seifert, a clinical nurse specialist and diabetes program coordinator for Banner – University Medical Center Phoenix. “If you have limitations in dexterity and joint mobility, visual or cognitive impairments, these can make it very difficult to administer insulin, remember proper dosage, and even open pill bottles.”
According to the Centers for Disease Control and Prevention (CDC), more than 34.2 million Americans have diabetes, and one in four of them (nearly 26%) are age 65 and older. One common problem, especially in this older population, is the use of multiple medications at one time, known as polypharmacy. Polypharmacy can pose a particular challenge as it can put those with diabetes at increased risk of having side effects from medications, including dizziness which can lead to falls. For this reason, it’s very important to inform every health care provider of the medications you take.
Managing diabetes successfully requires a broad range of habits and behaviors. The good news is that there are ways to navigate to effectively monitor and treat the disease and reduce the risk for other health problems. If you or a loved one are struggling with diabetes—especially the medical management of the disease—here are some important considerations to keep in mind.
6 Tips for Medication Safety for Older Adults with Diabetes
1. Keep a record of current medications and supplements.
Maintain a list of all active medications, including any over-the-counter medications and nutritional supplements you are taking, and bring this list with you to every doctor appointment. Because you may see multiple providers, this can help your doctor identify any potential interactions with prescription drugs and avoid duplication of medications.
“Sometimes you’re seeing multiple doctors – primary care, cardiologist, rheumatologist, etc. – and they may not all be talking to one another about your care,” Seifert said. “It’s important they are aware what you are taking, so they can advise and adjust medications appropriately.”
2. Understand what you are taking and why you are taking it.
In addition to keeping a list of current medications and supplements, you also want to be aware of dosage, time of day they should be taken and potential side effects. If you aren’t able to write this information down, ask your doctor and pharmacist to give you printed instructions to have on hand.
“One of the known potential side effects of medication, in particular with diabetes medications and insulin, is dizziness and lightheadedness, which can lead to falls and potential fractures or head injuries,” Seifert said.
3. Consider another form of your medication if you have joint limitations or swallowing challenges.
Don’t let difficulty opening bottles or injecting your insulin stop you from keeping on top of your diabetes and health. Many prescription and over-the-counter products are now available in a variety of dosage forms for patients who lack strength or joint mobility, have reduced hand coordination or sensation, or have difficulty swallowing pills.
There are many different forms: special bottle openers, liquid or inhaled medications, patches, suppositories and other dosage forms. If drawing insulin is difficult, switching to an insulin pen may be a good option as it can be easier to handle than a syringe and the numbers on the pen are larger to see.
“If you suffer from arthritis, shakiness or tremors, it may be hard for you to draw up the correct dose of insulin,” Seifert said. “This could result in errors which can lead to high or low blood sugar. It’s crucial you’re getting an accurate dose. Ask your doctor about using an insulin pen if you have difficulty using an insulin syringe and vial to draw up insulin.”
4. Remember to take your medications.
It is easy to forget if you’ve taken your diabetes medication, but luckily there are plenty of ways to keep you organized and on time. From simple labeled compartments to high-tech containers that beep when it’s time for a dose, you can purchase a variety of special pill boxes or other aids to remind you to take your medications. Taking the correct medication in the correct dose and at the correct time are key to proper medication management.
If you have a smartphone or tablet, you can set reminders throughout the day. There are many apps and online programs available to help you manage your diabetes. Your doctor and pharmacist can assist in developing a plan to best suit your schedule and comfort level.
5. Monitor your blood glucose.
Older adults with diabetes are at a higher risk for hypoglycemia (low blood sugar), which makes checking your glucose levels especially important. Your doctor can work with you on when and how to check your blood glucose levels and what tools and techniques can work for you. If you have physical limitations, there are several products that can make monitoring easier as well.
How often you should check your blood glucose varies from one person to the next, so it’s a good idea to ask your doctor about how often you should be testing. Also ask about your individual goal for glucose levels. To learn more about blood glucose levels and the signs and symptoms of low or high blood sugar, check out “The Basics of Blood Sugar.”
6. Don’t let lack of insurance coverage stop you from getting the care you deserve.
“The high cost of medications and the limited coverage on some health insurance plans are major contributors to why some people stop taking their medications or even ration them,” Seifert said.
For medications to be safe and effective, they must be taken in the correct dose, at a specific time and for a specific length of time. Don’t delay or ration your medicine. Here are some options to ensure you receive and take medication as prescribed:
- Ask your doctor about the use of generic medications or other alternatives. Some pharmaceutical companies also provide free medications or special discounts for low-income seniors. Your doctor may also have samples they can give you.
- Find a pharmacy that has the medication for the lowest price. You may even find that home delivery pharmacies are an affordable option.
- Don’t forget to enroll in the Medicare drug coverage – Medicare Part D. Part D covers medications or insulin, supplies for injecting or inhaling insulin, oral diabetes medications and other diabetes supplies such as glucose meters.
The scope and severity of problems that can occur with the management of diabetes are tremendous. To prevent problems or quickly nip them in the bud, talk to your doctor and health care team to ensure appropriate, safe and effective medication usage. They can work with you to decide on the best medication for you and adjust medications or insulin as needed. Work closely with your health care provider, as they have a vital role in ensuring you get the best care and treatment.
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