BS, weight, Targets for a 78 year old?

HelenM · #1 (**permalink**) 04-17-2008, 08:33 AM

This morning I was talking with an elderly acquaintance. He was diagnosed with type 2 about a year ago. The diabetologist (the same doc as I go to and shes good) has told him that his BS should not go above 140 (90 before meals) and that he needs to lose about 11kg .She is also worried about his blood pressure and wants him to see a cardiologist.He is very sceptical and says that his GP tells him not to worry about weight and that hes OK as long as his BS doesn't go above 200 too often. (apparently the pharmacist agrees with the GP). He doesn't appear to have changed his diet. (certainly didn't say no to a sticky Greek pastry this morning.....sorry I sound like the diabetes police). He tests once a day but really only to record the results.
My friend says that at his age it doesn't matter.It's far too late to change and probably won't make any difference to how long he lives. He doesn't want to reduce the quality of his life.
Part of me agrees, perhaps he doesn't really need the same targets/ restricitions as the rest of us.He might as well continue to enjoy his life. On the other hand is it possible that complications may arise very quickly causing him a miserable last few years?
What do others think?

fgummett · #2 (**permalink**) 04-17-2008, 08:51 AM

Depends if he want to live to be 100

but I can understand it being harder to change habits as one ages.

Penny · #3 (**permalink**) 04-17-2008, 09:41 AM

My MIL was diagnosed at 80, she is 90 now....she has donuts most mornings because she is "low". She claims her doctor told her to go to the ER if she "gets down to 110". You wouldn't believe it to hear her tell it, but she is really in pretty good shape for a 90 year old woman.

art · #4 (**permalink**) 04-17-2008, 10:48 AM

he's 78???
Party on.

To even think about his weight is silly. He's gotten this far.

Art

Alice · #5 (**permalink**) 04-17-2008, 12:53 PM

I would agree more with the diabetic doctor. Having said that, there is a tendency in the medical field to put older patients on a relaxed regime...for various reasons. But if he's in good health there should be no reason to avoid improvement.

There was a recent major Type 2 study that was stopped due to the increase in death by tighter control...but it was a confusing study involving heart medications as well...but overall (you'll have to google to find more info...there was a recent posting on DF) the study found that tightening the control on Type 2's didn't improve health as would have been thought...in fact, they were worried the reverse was true.

So, like everything else diabetic...it's all a personal prescription.

rzrbks · #6 (**permalink**) 04-17-2008, 01:30 PM

imHo

The older the patient being diagnosed, the less likely they are to be able to learn and understand all the aspects of having tight control.

my FIL has dealt with it, sorta, for 40+ years and he didn't care much until his second by-pass surgery--

now, he's 86 and is trying to get tighter control but has to deal with constant hypos--

the hypos, at this point in his life, are more likely to kill him than easing back his control.

Again, just mHo, and well all know the value of free advice.

BlueSky · #7 (**permalink**) 04-17-2008, 03:33 PM

Quote:

Originally Posted by Alice

.... There was a recent major Type 2 study that was stopped due to the increase in death by tighter control...

That is the ACCORD trial. It showed that intensively treating the symptoms of T2 diabetes worsens CVD outcomes. More people died from heart attacks. It really shouldn't be surprising. T2s were being intensively treated with insulin to drive the HBA1c lower than 6%. And adverse macrovascular consequences of the high insulin levels associated with intense insulin resistance are well know. The ACCORD study shows that just treating the symptom with drugs and/or insulin doesn't lead to the best outcome. Treating the cause, on the other hand, by losing weighty, getting more exercise, losing weight and cutting carbs has far more profound and lasting benefits.

Getting back to the original question, complications are probably well advanced in a 78 year old. And improving glycemic control through exercise, weight loss and better eating would no doubt slow the progression. It is really up to the individual to decide if the sacrifices involved are worth it. Elderly people tend to think more in the present, for obvious reasons, and we need to respect that. My 91 year old mother has skin cancer on her nose and she doesn't want to have it cut out. It doesn't worry her now, and she doesn't think too far into the future.