1. What is type 2 diabetes?

Type 2 diabetes is a condition where your body has trouble using or making enough insulin. Insulin is a hormone that helps move sugar (glucose) from your blood into your cells for energy.

With type 2 diabetes, your body may not respond well to insulin (insulin resistance), and/or may not make enough insulin over time. This can cause high blood sugar levels.

If blood sugar stays high for many years, it can damage:

Blood vessels
Nerves
Eyes
Kidneys
Feet and legs

Did you know?

You may or may not feel symptoms when your blood sugar is high. Some people feel very thirsty, very tired, or need to urinate more often. Others feel almost nothing at first.

2. Why type 2 diabetes matters more in older adults

Type 2 diabetes can occur at any age, but it raises special concerns in older adults because:

Many older adults have other conditions, such as high blood pressure or heart disease
Some diabetes medications can cause low blood sugar, which may be more dangerous in older age
Low blood sugar (hypoglycemia) can lead to falls, confusion, or accidents
Changes in vision, nerve feeling, or balance can increase the risk of foot problems

For older adults

Your health-care provider may choose different blood sugar targets for you than for a younger person, and may prefer some medications over others to reduce the risk of low blood sugar.

3. How doctors usually treat type 2 diabetes

Your treatment is personalized. Health-care providers often look at:

Your blood sugar levels and A1C (a lab test that shows average blood sugar over a few months)
Your age and overall health
Other conditions, such as heart or kidney disease
All the medications and supplements you already take
How regular your meals and activity levels are

Treatment commonly includes:

Food and eating patterns

That support more stable blood sugar

Physical activity

As safely as you are able

Medications

Taken by mouth

Insulin injections

Or other injectable medicines, in some cases

Important

This website does not tell you which medications or doses are right for you. Only your doctor or nurse practitioner can make that decision.

4. Common types of diabetes medicines in older adults

Health-care providers may choose from several types of medications for type 2 diabetes:

Metformin

Often used early; helps your body use insulin better

Sulfonylureas

Help your body release more insulin

DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists

Newer medication families

Insulin

Injections that replace or supplement your body's insulin

Each type has its own possible benefits and side effects, especially in older adults or people with kidney, heart, or other medical problems. Some medicines can cause low blood sugar (hypoglycemia).

Tip

If you are not sure which diabetes medications you are on, ask your pharmacist for a clear printed list.

5. Possible side effects older adults may notice

Not everyone has side effects, and side effects are different for each medication. Possible issues include:

Upset stomach, nausea, or diarrhea (for some oral diabetes medicines)
Loss of appetite or weight changes
Swelling in legs or feet (with certain medications)
Increased urination or thirst

Signs of low blood sugar (hypoglycemia)

Feeling shaky, sweaty, or very hungry
Sudden weakness or dizziness
Trouble thinking clearly or confusion
Sudden mood changes

If you suspect low blood sugar, follow the plan your health-care provider has given you. If you do not have a clear plan, tell your provider at your next visit.

Important

Do not stop your diabetes medications on your own unless your health-care provider tells you to. Stopping suddenly may cause your blood sugar to rise too high.

6. Habits and lifestyle that may help

Many diabetes guidelines suggest that certain daily habits can help manage blood sugar along with medications. What is safe and realistic is different for each person, especially in older age.

Food and eating patterns

Have regular meals and snacks (if advised), rather than skipping and then overeating
Include vegetables at most meals, in forms you can chew and digest comfortably
Choose higher-fibre foods more often (whole grain bread and cereals, beans, lentils, fruits, vegetables)
Be mindful of added sugars in drinks and sweets; water is often a better everyday drink, if safe for you
If possible, work with a dietitian or your provider to find a meal pattern that fits your culture, budget, teeth, digestion, and medications

Movement and activity

Gentle activities such as walking, light stretching, or chair exercises can help your body use insulin better
Aim for regular, safe movement, even a few minutes at a time, as your provider recommends
Balance and strength exercises, if safe, may help reduce falls and keep you independent longer

Foot and skin care

Check your feet regularly for cuts, blisters, or colour changes
Wear comfortable, well-fitting shoes and clean socks
Tell your provider if you notice sores that are not healing

Always ask first

Always ask your doctor, nurse practitioner, or another health professional what food and activity changes are safe and realistic for you. Do not make major changes to your diet, exercise, or supplements without checking first.

7. When to call your doctor, nurse practitioner, or pharmacist

(Non-urgent)

Contact your health-care provider or pharmacist if:

Your blood sugar readings are often higher or lower than the target they gave you
You are having frequent low blood sugar episodes
You feel more tired, thirsty, or are urinating more often than usual
You notice changes in your vision, or tingling or numbness in your hands or feet
You have sores or cuts on your feet that are not healing
You are starting a new over-the-counter medicine, vitamin, or herbal product and are not sure if it is safe
You are having trouble affording, remembering, or organizing your medications

8. When to call 911 or go to the emergency department

Call 911 immediately if:

You are extremely weak, confused, or cannot stay awake
You have trouble breathing
You have chest pain or pressure that does not go away
You have signs of very high blood sugar along with feeling very unwell (such as heavy breathing, stomach pain, vomiting, or confusion)
You have signs of a stroke (sudden weakness, numbness, trouble speaking, or severe headache)

If possible, do not drive yourself. Ask someone to call for you or call an ambulance.

9. Questions to ask your doctor or nurse practitioner

You can print these questions and bring them to your next appointment:

What blood sugar and A1C goals are right for me at my age and health?

Are any of my diabetes medications more likely to cause low blood sugar?

What should I do if my blood sugar goes too low or too high?

Are there changes in my food or activity that you recommend for me?

How do my diabetes medications interact with my other medications?

How often should my eyes, feet, and kidneys be checked?

Can I speak with a dietitian or diabetes educator?

🩺 Type 2 Diabetes in Older Adults