How to avoid diabetes in older age

Changes to help avoid a diabetes diagnosis in older age

Diabetes is a growing problem in older adults, with numbers in the UK reaching 5 million for the first time ever in 2023. Understanding the risks of developing diabetes is important, and taking steps as early as possible to prevent the onset of the condition can lead to a healthier lifestyle, and an increased quality of life in older age. Here, we are taking a closer look at diabetes, its many symptoms and the health risks it can cause. Our guide will look at ways you can prevent this condition in later life, with known methods like adopting healthy eating habits and setting up a regular exercise routine, as well as lesser-known methods of prevention. Whether you are looking to manage your own diabetes risk, or to support a loved one in minimising their risk, we can help. At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about diabetes in older adults, we can help.

What is diabetes?

Diabetes is a chronic health condition causing high levels of glucose in a person’s blood. This occurs when the pancreas cannot produce sufficient insulin (a hormone that helps to regulate blood glucose) or when the body cannot utilise the insulin it does produce. Without proper insulin function, glucose can accumulate in the person’s bloodstream which can lead to several health complications. Symptoms of diabetes can include an increase in thirst, frequent urination, tiredness and blurred vision, among others. In older adults, symptoms may be slightly different and can be more difficult to manage, with symptoms such as:

• Increased thirst and urination
• Increased hunger
• Fatigue
• Blurred vision
• Numbness or a tingling sensation in the feet or hands
• Sores on skin that do not heal
• Unexplained weight loss

Usually this condition can be managed through medication, but it requires certain lifestyle changes such as diet changes, regular exercise, and monitoring blood sugar levels to keep any serious health issues at bay. While these must be considered for anyone with diabetes, those who have a higher risk of developing the condition – such as older adults – should think about starting some of these lifestyle changes early to prevent it from forming in the first place. Diabetes can lead to severe health concerns such as kidney failure, strokes, heart attacks, blindness, and even lower limb amputation, so taking your health seriously in older age is vital in order to avoid this preventable condition and maintain your quality of life for as long as possible. There are three variations of diabetes older adults should be aware of; type 1 diabetes, type 2 diabetes, and pre-diabetes. 

Type 1 diabetes

This is when a person’s body does not produce enough (or no) insulin on its own. While older adults can develop type 1 diabetes, this is rare, as this type of diabetes most often starts in childhood or young adulthood. This type of diabetes cannot be prevented, so it will need maintenance for the rest of the person’s life, which includes taking insulin every day.

Type 2 diabetes

This is when a person’s body produces insulin but cannot utilise it effectively. This is the most common form of diabetes that affects more than 95% of those with diabetes. It often develops in adulthood, and the risk factors for this condition are higher if a person is overweight, leads a sedentary lifestyle, has a family history of diabetes, has a history of gestational diabetes (which can occur during pregnancy), or is of Asian (including Indian, Pakistani and Bangladeshi) Chinese, Black African and Black Caribbean ethnicity. Studies show older adults have a higher risk of developing type 2 diabetes due to the combination of increased insulin resistance and impaired pancreatic function, which both tend to occur in older adults. Those aged 65+ show the highest prevalence of diabetes of any age group. 

Pre-diabetes

Before type 2 diabetes develops, healthcare professionals can identify something called pre-diabetes, which can act as a warning sign for anyone who is close to developing type 2 diabetes. Pre-diabetes is characterised by glucose levels that are concerning, but not yet at the stage where someone would be diagnosed as having type 2 diabetes. At this stage, diabetes could still be prevented through some of the lifestyle changes covered below. Studies show type 2 diabetes is the most common of the two, and is prevalent in older age groups. Risk factors for developing type 2 diabetes include genetics and certain medical conditions, but one of the most common causes is lifestyle and being overweight. If you are concerned about your personal risk of developing type 2 diabetes, you should speak to your GP about this, as they can recommend certain lifestyle modifications or ways to reduce your risk. You can also use the Diabetes Risk Management Calculator created by the National Institute of Diabetes and Digestive and Kidney Diseases to estimate your personal risk. Knowing your risk is important, since diabetes in older adults has been linked to higher mortality rates, and its complications can significantly impact quality of life and independence in older adults.

What healthy eating habits can older adults adopt to minimise their risk of developing diabetes?

Maintaining a healthy diet is one of the most important things an older adult can do to minimise their risk of developing type 2 diabetes, and there are a number of changes and swaps that can help. These include: 

• Eat whole foods – A great rule of thumb is to stick to whole foods, which means foods that have not been turned into something else or processed. For example, fruit, nuts, vegetables, and so on. Keep in mind that while whole foods such as fruit and nuts are healthy options compared to other foods, they can still be high in calories or high in sugar content, so should be consumed in moderation.
• Reduce red meat intake – Try to stick to eating more lean proteins rather than fat and red meat. Diabetes UK states that more red and processed meats in your diet, such as bacon and sausages, are all associated with an increased risk of health conditions such as heart issues and type 2 diabetes. 
• Reduce sugar – Type 2 diabetes is a condition characterised by elevated blood sugar levels, so reducing blood sugar is the key to avoiding this. Cutting back on sugary foods can help to regulate blood sugar levels.  
• Reduce refined carbs and processed foods – Although type 2 diabetes is primarily associated with sugary foods, many other types of food are also high in sugar. Reducing refined carbohydrates and processed foods can also help to regulate blood sugar levels, and this could mean cutting out things like white bread, white rice, certain cereals, and more. Instead, opt for wholegrains like brown rice, whole wheat pasta, wholegrain bread and similar foods. 
• Snack healthily – Often we don’t realise how many extra calories we are consuming through snacks each day, and when many of these are also processed we could be doing damage to our body one snack at a time. Find some healthy snack options you like, such as seeds, fruit or yoghurts, and make sure you have these stocked in your home instead of unhealthy alternatives. 
• Follow a plan – According to research from the National Institute of Diabetes and Digestive and Kidney Diseases, you can prevent or delay type 2 diabetes by reducing your body weight with a reduced-calorie eating plan and an exercise regime. Following a plan and tracking your progress could help you see more results. 
• Set a goal – The NIDDK also recommends setting a weight loss goal so you have something to aim for to enhance your motivation. Research finds setting targets can lead to greater long‐term weight loss, so instead of saying “I want to lose weight to reduce my risk of diabetes”, write on your plan a more specific goal such as “I want to lose 5 pounds by April”. 
• Don’t neglect healthy fats – When trying to lose weight, one of the first things people do is cut out all sources of fat, but it is important to remember there are healthy fats and unhealthy fats. Diabetes UK recommends keeping healthier fats in your diet as we need these to sustain ourselves. Things like oily fish, avocados, nuts and seeds are all sources of healthy fats.  
• Keep an eye on your portions – Maintaining a healthy weight often means keeping portion control in check to avoid overeating. If you struggle with this, it can help to weigh your food, use a smaller plate, and be more mindful when eating. For example, sit at the table and pay attention to your food rather than eating in front of the TV. 

Always speak to a medical professional before making a drastic change to your diet to ensure you are not neglecting any particular foods, or consuming something that could interfere with medications. It can be overwhelming to think about dieting, but be open to the possibility that you may enjoy eating a healthy diet and will feel better for it. You may find more diet ideas in our guide to what foods older adults should avoid.

How important is weight management in avoiding diabetes later in life?

Weight management is vital in avoiding type 2 diabetes later in life, as excess body weight can increase insulin resistance, which is a key factor in its development. Losing weight is important for those who are overweight, as they have a higher risk of developing diabetes. Sustaining a balanced diet and regular exercise routine should help you to lose weight anyway, but paying attention to things like calories (if you are comfortable doing so and do not have a history of disordered eating) can help to reduce weight, which should reduce blood sugar levels and, as a result, diabetes risk. Even in very small amounts, weight loss can significantly impact blood glucose control and a person’s metabolic health. You could start to see significant changes when losing even a small amount of weight, as research from the Diabetes Prevention Program found study participants who did 30 minutes of physical activity every day lost at least 7% of their body weight and cut their risk of type 2 diabetes by 58%. Remember, always speak to a healthcare professional before embarking on a weight loss journey for advice, and as a safety precaution. 

What else can older adults do to reduce their risk of diabetes?

Maintaining your weight through healthy eating and exercise are two of the most significant factors when it comes to reducing risk of type 2 diabetes, but a few other things can help. First, stopping smoking can help to reduce your risk. As well as increasing the risk of certain cancers, smoking can also increase your risk of type 2 diabetes, with smokers proven to have a higher risk of developing this in the first place, as well as a higher risk of complications if they do get diabetes. Also, reducing your alcohol intake is a good idea if you are worried about developing type 2 diabetes. Drinking alcohol in excess has been found to increase risk of developing diabetes due to its connection to weight gain, so be mindful of how much you are drinking each week, and speak to your doctor if you need help to cut back on this. Chronicstresscan trigger the release of stress hormones like cortisol and adrenaline, which are known to raise blood sugar levels and contribute to insulin resistance. Persistent stress can also contribute to unhealthy behaviours like poor diet, lack of exercise and smoking, which can further increase diabetes risk. Studies suggest the release of catecholamines and increase of serum glucocorticoid concentrations caused by stress can increase the need for insulin and insulin resistance. You can try to reduce your stress levels by adding relaxation techniques into your routine (such as meditation, or spending time in nature), addressing any particular sources of stress (such as work or relationship stress), or increasing your physical activity. For older adults, activities such as gardening could help to relieve stress, or more social interaction with people in their community could also help. In addition, getting more sleep is a crucial but little-known way to reduce the risk of type 2 diabetes. This should be high on your list of lifestyle modifications, as sleep helps regulate hormones that control blood sugar levels and insulin sensitivity. Chronic sleep deprivation can disrupt these hormones, leading to higher blood sugar levels and increased insulin resistance. Poor sleep also negatively impacts hormones that regulate appetite, which can lead to overeating and weight gain over time. Prioritise quality sleep and try to get between 7 and 9 hours each night if you can. This supports your overall metabolic health and significantly lowers the risk of developing type 2 diabetes. That said, older adults may need less sleep than this, so focus on simply getting enough rest if you are not sleeping for 7 to 9 hours a night. Studies suggest the importance of sleep for regulating physiologic functions relating to metabolism, and there is evidence to suggest sleep habits and disordered sleep could be related to diabetes risk. A 2024 study found those who slept less than 6 hours each day had a higher risk of developing type 2 diabetes compared to those sleeping 7 to 8 hours a night. You can learn more about sleep in our guide to healthy sleep and insomnia in older adults.

How often should older adults check for diabetes?

Older adults will find it best to check for diabetesat least once a year if possible, but those with higher risk factors like a family history of diabetes or obesity should consider more frequent screenings, such as every six months. Your GP can recommend what they think is appropriate based on your situation. Regular monitoring might include fasting blood sugar tests, HbA1c tests to assess blood sugar levels, and other health indicators. These screenings are essential for early detection, allowing time for intervention and appropriate management to prevent complications down the line. If your doctor suspects your risk of type 2 diabetes has increased, or you have developed pre-diabetes, they may recommend certain medications to help lower your risk levels by controlling your blood sugar levels. How can I support an elderly loved one in minimising their diabetes risk? If you have a loved one who is worried about developing type 2 diabetes, there are ways you can support them to help them remain in their best health with a combination of encouragement, accountability and advice. Your loved one will need to make some lifestyle changes, which could be drastic depending on their current lifestyle. You can help in a number of ways:

• Educate them about diabetes risk factors and prevention strategies
• Share information on local exercise classes, nutrition workshops and support groups
• Provide emotional support when things get tougher during their diet 
• Discuss healthy choices they can make to improve their diet
• Cook them healthy meals, or if you are going out to eat, choose restaurants where they can find healthy options 
• Attend healthcare appointments with them for support and take in the information 
• Do exercise with them so it is more enjoyable and social for them 
• Encourage them to move around their home more or take up more active hobbies 
• Offer support if they are giving up smoking or drinking alcohol 
• Help them to keep track of the diet they are on, count calories, monitor their progress, or whatever else would help them to continue progressing 
• Do what you can to relieve any stress they may have in their life 
• Help them keep track of any medications they are taking to minimise diabetes risk 
• Organise regular companionship or home help visits so there is always someone around to offer encouragement and provide healthy food options, even if you are not available

By fostering a supportive and proactive environment, you can reduce your loved one’s risk of developing type 2 diabetes, as well as improve their overall wellbeing. If you are caring for someone with diabetes and would like to find out more information, you can find resources online such as helplines and educational materials specifically catering to older adults. Visit Diabetes UK, the International Diabetes Federation, or Diabetes.co.uk for more information.  If your loved one eventually needs support for diabetes management such as insulin therapy, our Care Professionals are trained to the highest clinical standards and can check blood sugar, administer insulin, clean and maintain equipment, and order stock, which is all highly important when helping someone with diabetes. They can also prepare healthy meals, supervise safe exercise, promptly respond to low or high blood sugar readings and more, so receiving help from a trained carer can enhance independence in older adults.For the most part, a healthy diet, regular exercise and movement, and a few other lifestyle tweaks can really change the trajectory of an older adult’s health by minimising their risk of developing type 2 diabetes at some point in the future. The sooner you can begin living a healthier lifestyle, the better. Do not be afraid to ask for help if you are struggling to make changes. Whether you speak to a trusted loved one or a professional home carer, you can start to make small changes now that will eventually lead to a more positive, health-conscious lifestyle. If you would like to discuss your need for home care and healthy lifestyle encouragement, or diabetes monitoring, you can reach out to your local Home Instead team to discuss your needs.We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss.