Diabetes-Related Complications in Older People

Over time, high blood glucose levels in people with diabetes can lead to diabetes-related complications.

Extra care must be provided to ensure older people’s quality of life and reduce the risk of diabetes-related complications which can affect their whole body, including kidneys, eyes, feet, nerves and heart.

Important: Older people with diabetes should have regular diabetes-related complication assessments by a multidisciplinary team, including a podiatrist and dentist.

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Foot care

Older people with diabetes can develop foot problems due to poor circulation and nerve damage. Daily foot care activities, such as the ones listed below, can help keep feet healthy and detect and treat foot problems early.

Wash and dry the older person’s feet thoroughly, including between their toes
Moisturise each foot, avoiding between the toes
Check the older person’s shoes and socks to ensure they are a good fit.

Signs and symptoms of foot problems

If you see any of the following changes, report them to your supervisor or registered nurse:

blisters, corns, bunions, ingrown and/or thickened toenails, discoloured toenails or arthritis
ulceration
slow-healing wounds
skin tears, cuts and abrasions
pain or different sensations in the feet, such as burning, tingling, or increased sensitivity to pain or touch
different skin colour, moisture or temperature
foot deformities
walking abnormally.

Oral health care

Older people with diabetes have an increased risk of tooth decay and gum disease because of the higher amount of glucose in their saliva. Diabetes can also contribute to dry mouth and ulceration.

Maintaining healthy blood glucose levels can help reduce the risk of tooth decay and gum disease. If you notice any changes in your client’s teeth or gums, report this to your supervisor.

Skin care

As skin ages, it becomes thinner and loses stretchiness and moisture. As a result, older people’s skin can damage more easily and take longer to heal. Diabetes can amplify this process. Older people with diabetes should have skin care included in their individualised care plan.

To help an older person look after their skin:

avoid over-washing their skin and use warm (not hot) water
use a pH-neutral soap
pat (don’t rub) their skin dry
assist with difficult-to-reach areas, such as their breast skin folds, between their toes, under the arms and in the groin and buttock area
moisturise their body after each wash (but not between the toes).

If the older person has limited mobility and sits or lies down for long periods of time, help them move their body so they don’t develop pressure sores. This should be included in their individualised care plan.