Elderly individuals require a balanced diet and rest, maintaining a relaxed state of mind, while avoiding strong emotional stressors to prevent fluctuations in blood sugar levels. When experiencing symptoms of high or low blood sugar, especially if these occur frequently, consultation with a physician for examination and medication guidance is essential.
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| Rapid blood sugar test (Photo: TTO) |
The main type of sugar present in the blood is glucose, so the correct term for blood sugar levels should be glucose levels (hereafter abbreviated as G-h).
Generally, normal G-h levels (measured when the body is at rest and fasting) range from 0.8-1.2 g/l (that is, 4.4-6.6 mmol/L). This concentration is sufficient to nourish brain cells, while other cells require insulin support. When G-h drops to 0.7 g/l, it is considered low, and at 0.6 g/l (or 3.3 mmol/L) or below, it is classified as hypoglycemia. Levels above 1.3 g/l (or 7.2 mmol/L) are considered high.
As people age, the regulation of G-h becomes less responsive and reliable, leading to an increased risk of high or low G-h.
Hypoglycemia in the Elderly
Hypoglycemia due to sudden increased usage, while the glucose reserves in the liver are not plentiful or mobilized in time. Generally, the liver’s ability to store glycogen decreases with age, especially when fasting (some elderly individuals may require multiple meals). When exposed to cold environments (such as suddenly going out into the cold without proper clothing or staying outside for extended periods), younger individuals can adapt more easily, while older adults are more prone to hypoglycemia.
Similarly, when older adults exert themselves suddenly without proper warm-up to adapt their bodies. For example, suddenly performing a series of relatively strenuous exercises or exercising on an empty stomach… Prolonged anger without self-control can also trigger hypoglycemia.
Hypoglycemia due to decreased liver reserves. In elderly individuals, even after eating, the total glucose in the liver remains low. This condition is more pronounced if chronic liver diseases (such as cirrhosis or liver failure) are present. Notably, individuals with a history of alcohol abuse… Many have developed a habit of drinking without eating, which can exacerbate the issue. In general, elderly individuals should eat multiple meals, especially a late-night meal (for example, a glass of milk at 9 PM).
A sign indicating nighttime hypoglycemia is restless sleep, with dreams of eating plentiful and delicious food. A risk is that the body’s protein reserves may gradually deplete as they are converted into glucose to counteract hypoglycemia, leading to malnutrition (which is difficult to recover from).
Hypoglycemia due to excessive use of diabetes medications (patients need to be very cautious of this complication). It may occur if the patient follows a diet that is too low in glucose in an effort to actively manage their condition and prevent complications. It is important to remember that even with diabetes, patients still require an adequate amount of carbohydrates, primarily whole-grain carbohydrates. However, most diabetic patients experience hypoglycemia often due to excessive use of blood sugar-lowering medications (in hopes of better controlling the disease) without following their physician’s guidance or monitoring their G-h levels regularly.
Brain cells exclusively utilize glucose as fuel, unlike other cells that can use fats and proteins; therefore, if G-h suddenly drops to 0.7 g/l, immediate neurological symptoms may appear: tremors, blurred vision, dizziness; if it decreases to 0.5 g/l, symptoms may include weakness, faintness, cold sweats, rapid heartbeat, and weak pulse… Further drops can lead to jaw stiffness, confusion, loss of muscle tone (collapse), and coma. For the same level of G-h reduction, older adults generally exhibit a more severe clinical picture, making recovery more challenging (compared to younger individuals).
If G-h decreases gradually, the initial symptoms may include intense hunger and strong digestive contractions (stomach cramps, gurgling). However, many older adults lose their sense of hunger, meaning they miss an early symptom that could prompt timely diagnosis. Subsequent symptoms include trembling, blurred vision, cold sweating, and weakness in the limbs; due to the prolonged progression, younger individuals have sufficient time to adjust (mobilizing proteins); conversely, this mobilization appears sluggish and less effective in older adults, resulting in more severe consequences: potential coma, prolonged weakness, or difficulty recovering from depleted protein reserves… In general, if an elderly person has a reduced appetite, it is advisable for them to eat several small meals throughout the day.
In this situation, elderly individuals need to consume easily absorbable carbohydrates immediately: candies, pastries, and in urgent cases, sugar water (not artificial sweeteners), fruit juices, or milk… In emergencies, intravenous glucose may be necessary.
Hyperglycemia in the Elderly
In contrast to hypoglycemia (which has adverse consequences), hyperglycemia is usually temporary (occurring during physical activity or when experiencing strong emotional states: anger, fear, frustration, worry…). For older adults, it is important to remember that if these conditions persist and occur frequently, they can lead to increased adrenaline secretion, liver glycogen depletion—threatening the transition to hypoglycemia. Moreover, these psychological states can negatively impact cardiovascular health and blood pressure.
Persistent hyperglycemia is found in diabetes. In older adults, this condition does not stem from a lack of insulin but rather from the cells’ ineffective use of this hormone; therefore, generally, insulin treatment is not necessary in the early years (as it is for younger individuals). There are numerous long-term medications available, but the appropriate choice should be guided by a physician, and patients should monitor their own levels.
Early detection of diabetes in the elderly is not easy because high G-h does not usually present any symptoms that prompt patients to pay attention. However, individuals over 60 should have their G-h measured regularly as per medical guidelines. Testing should not be done with urine (as the presence of glucose in urine indicates that the disease has progressed for some time).
Hyperglycemia often does not manifest externally with symptoms that are noticeable to the patient. Detection requires measuring G-h levels. Many cases show glucose in urine (when G-h exceeds 1.7 g/l) while the individual is completely unaware; it is only upon accidental measurement that diabetes is uncovered.
These are two common symptoms in the elderly that can be prevented. To prevent disease, elderly individuals need to maintain a balanced diet and rest, keep their minds relaxed, and avoid strong emotional stressors. When experiencing signs of high or low blood sugar, especially if these occur frequently, a physician should be consulted for examination and medication guidance.
