Just when you thought you knew of all the challenging complications of living with Type 1 diabetes … aging with Type 1 diabetes.  I think I can track back some of these changes to my mid 50’s and perimenopause/menopause.  Without the hormonal variability, things then seemed to quiet down.  But after 50+ years with this disease, I’m wondering what’s next. 

Several months back, the issue of aging with diabetes was presented at the T1D Exchange’s Annual Meeting.  With incredible breakthroughs in diabetes technology, therapy and clinical care, people with type 1 diabetes are living longer than ever. But as people age, they take on a whole separate host of challenges that are compounded by T1D. Many fear they will not have the self-reliance, care, support, or financial resources necessary to manage their blood sugar and continue to live well with diabetes in their golden years.

“This is a new problem, based on our recent success in treating T1D,” said Dr. Nick Argento, an endocrinologist and person with diabetes (PWD). “The Joslin 50-year survivors used to be sort of an elite group. That’s not true anymore. Now, it’s expected, not the exception.”

Joining Argento on stage was Paul Madden, Bunny Kasper, and Sandy Brooks, each with a different diabetes experience, but all in their later stages of life.

Bunny Kasper, who is in her mid-seventies and has lived with diabetes most of her adult life, volunteers as a support group leader for families with children who have T1D. She shared that this group of parents recently commented that she should find diabetes management easier because she’s been doing it for so long. But what they didn’t understand was how much more tired she is at this age, and that it’s actually harder, not easier, after all these years.  “There’s just very little understanding about the elder generation and what we deal with,” said Kasper.

In addition to physical wear and tear, the panelists shared how much fear plays a role in their daily lives with T1D, and how vulnerable they all feel about their future. “I’m afraid of being alone, and not being supported with my care,” said Paul Madden, 66, diagnosed 55 years ago. Argento shares the same fear, and has already seen this issue in his own T1D patients.

“Their network has broken down. They’ve had a spouse who was their advocate and assistant, but then has a stroke or develops dementia or dies and suddenly, they’re not present anymore.”

Sandy Brooks, a registered nurse and surgical type 1, says nursing homes are even less prepared and educated about insulin dependency. “There are great people there who work hard, but T1D adds an aspect that you don’t learn about in nursing or medical school.”

The cost of diabetes management and access to technology, therapies and care, are also a big worry for these panelists, especially as many of them are or will soon be eligible for Medicare.

You can listen to podcast episode of this event by clicking here: https://www.podbean.com/media/share/pb-ny8f7-7e17c9

Read more:  The New Complication: Aging with Type 1 Diabetes

So let’s talk about “getting older.”  According to Feeling Older? Her’s How to Embrace it by Christopher Mele in Smarter Living, The New Yorrk TImes, 12 September 2017, Studies show that people start feeling old in their 60s, and a Pew Research Center survey found that nearly 3,000 respondents said 68 was the average age at which old age begins.

The realization that you are getting older can come in waves. You watch movies and point to the actors, saying: “She’s dead. Oh, he’s dead, too.” Your parents move to a retirement community they call God’s waiting room. You hear more snap, crackle and pop in your joints than in your breakfast cereal. In society, youthfulness is glorified and getting older is cast as something to avoid, but as your age increases, your quality of life does not necessarily have to decrease, experts said.

Daniel B. Kaplan, an assistant professor of social work at Adelphi University in Garden City, N.Y., said in an email that living to an advanced age was a relatively recent achievement.  “The average human life span gained more years during the 20th century than in all prior millennia combined,” he wrote, adding that the average life expectancy in the United States is 79.1.

So what can you do:

• Gain perspective. Your outlook can make a difference. 
• Diversity your friends. Having friends from mulitple generations can help head off the loneliness that can come when others move, die, get sick or are no longer mobile.
• Get ready.  The quality of your later life is partly under your control. Choices about lifestyles and behaviors can influence the effects of so-called secondary aging. Exercise and proper sleeping and eating habits will help your physical health, which will benefit your mental and cognitive health. Seek financial advice to help adapt to changes in your income and plan for the costs of health care.
• Embrace the positives.  Although there can be declines in health and income, “the vast majority of older adults enjoy improvements in the emotional aspects of life” because they are more focused on positive information.
• Reject ageist attitudes.  Though it is true that as we age, we may gain some weight and lose some of our intellectual abilities, it is no reason to give in to stereotypes about older adults.

Read more: Feeling Older? Here’s How to Embrace It

And from Laddie Lindahl of TestGuessandGo.com, Living in the Orange: When Diabetes is Tough, 19 March 2018, who discusses, the challenges she’s dealing with as she moves into the “age of Medicare.” 

Diabetes is hard these days. I am usually a good problem solver and lately my usual fixes aren’t working. I am seeing patterns that differ from my normal ones. I am not sick. I am not on new medications. I am long past menopause and don’t think I’m dealing with raging or sagging hormones. Other things are sagging but that is a different story for a different day and a different audience.

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