Older Adults with Diabetes Need the Following Assessments

Medical History

A healthcare professional will complete a detailed medical history and physical exam because diabetes increases the risk of other health conditions. These include heart disease, circulation problems, high blood pressure, high cholesterol, and liver disease. Some of these conditions can affect blood sugar control.

It is also important to stay current with:

• Eye care (optometrist or ophthalmologist)
• Dental care (dentist)
• Foot care (podiatrist)

Medication Review

A healthcare provider will carefully review all medications, since some can raise blood sugar levels. They will also check for drug interactions, duplicate medications, and side effects.

It is important to keep a complete list of all prescriptions, over-the-counter medications, vitamins, herbal products, and other supplements.

Geriatrics Assessment

This assessment looks at common health problems in older adults, called geriatric syndromes. These are not single diseases but common patterns of health concerns in aging. Older adults are at higher risk for these problems.

Helpful assessments include:

• A functional assessment to determine whether a person can walk safely and whether they can increase physical activity.
• A cognitive and depression assessment to determine whether a person can manage their diabetes independently and what type of support they may need. For example, a family member may need to help manage diabetes care.

Personal Health Goals

After these assessments, the healthcare provider will work with the older adult and any caregivers to set personal health goals. These goals should match the person’s overall health and life situation.

For example, a person with a limited life expectancy or difficulty managing diabetes may not benefit from very strict blood sugar control. Blood sugar levels that are too low can be dangerous and may cause stress or confusion.

Lifestyle Changes

Lifestyle changes are often the first step in managing diabetes and preventing related health problems. The recommended changes depend on age and other medical conditions.

These changes may include improving diet to help control blood sugar, losing a specific amount of weight, and increasing physical activity.

Medication Treatment

If lifestyle changes are not enough to control type 2 diabetes, medications may be needed to help keep blood sugar levels within a safe range. 

There are a growing number of medications that are used to treat diabetes. They work in different ways.  Some are pills that can be taken by mouth and others require an injection through a small needle. 

For each medication, side effects and monitoring needs may differ depending on a person’s health conditions, other medications, and age. Target A1c levels and monitoring plans are individualized.

• Blood sugar goals may also differ depending on the setting. For example, glucose targets in a hospital, nursing home, or for someone living at home may not be the same. Blood sugar control that is too strict can lead to dangerous hypoglycemia (low blood sugar). A healthcare provider will help make safe medication adjustments to manage diabetes.

Each medication has benefits and possible side effects. Ask about side effects such as stomach upset, liver problems, heart failure, or weight loss. Some of these medications may also help to treat heart or kidney disease that is common in people with diabetes or help with weight loss to make diabetes more easy to control. 

Talk with your healthcare provider about which medication or combination is best for you. A pharmacist can also help review and explain your medications.

Cautions

When using medications to treat diabetes, blood sugar levels can sometimes drop too low (this is called hypoglycemia). Frail older adults are at higher risk because they may not notice early warning signs of low blood sugar.

Be sure to review and share all your medications with your healthcare provider. This includes vitamins, herbal products, dietary supplements, and over-the-counter medications. It is important to understand:

• Why you are taking each medication
• How and when to take it
• Common side effects to watch for

You also need to: 

• Keep a current list of all your medications with you in case of an emergency.
• Bring your actual medications to appointments so your healthcare provider can confirm that the directions are correct and up to date.
• Fill all prescriptions at the same pharmacy, if possible. A pharmacist can check for possible drug interactions.
• Read the information that comes with your medications. Ask your healthcare provider or pharmacist if you have any questions.

Monitoring Glucose Levels

If a person takes non-insulin medications for diabetes, they may not need to check blood sugar every day. An A1c test, usually done every three to six months, may be enough to monitor diabetes control.

If a person takes insulin, their healthcare provider may recommend checking blood sugar at least once a day. This helps adjust insulin doses as needed. The two types of monitoring are:

• A blood glucose monitor (glucometer). It is helpful to write down the results and bring them to medical appointments for review.
• A continuous glucose monitor (CGM). This device uses a small sensor placed just under the skin to measure blood sugar levels throughout the day and night. It is especially helpful for people who take multiple insulin injections each day, need to check blood sugar often, or are at risk for low blood sugar (hypoglycemia). Ask your healthcare provider if this option may be right for you.

Hemoglobin A1c Level

People with diabetes should work with their healthcare provider to decide the best A1c goal for them. Treatment and management plans depend on:

• Functional and cognitive status
• Other health conditions
• Life expectancy

Even small improvements in blood sugar control can lead to meaningful improvements in overall health.

Last Reviewed and Updated: August 2026 
By: AGS/HiAF Public Education Committee, HealthinAging.org Content Reviewers