Diabetes in older adults: low blood sugar signs, foot care and a daily plan

In older adults the goal of diabetes care is usually safe, stable blood sugar rather than the lowest possible number. Low blood sugar (hypoglycaemia) can be harder to spot in later life and can lead to falls and confusion. The doctor sets targets and medicine or insulin doses; the family and caregiver follow the plan consistently and notice changes.

Signs of low blood sugar

• Sweating, shaking, palpitations, sudden hunger
• Restlessness, irritability, unusual behaviour
• Blurred vision, dizziness, light-headedness
• Confusion, drowsiness, difficulty speaking
• Nightmares, night sweats or a morning headache

In older people the only sign may be seeming “a bit odd today”. Because these signs can be mistaken for dementia or tiredness, checking the blood sugar whenever in doubt is the safest approach.

What to do when blood sugar is low

Follow the written plan from the doctor. In many plans, if the person is alert and able to swallow, they are given fast-acting sugar (fruit juice, a sugary drink or glucose tablets), the level is rechecked after 10–15 minutes and the step repeated if needed. Once it has risen, a snack or meal follows. If the person is unconscious, having a seizure or cannot swallow safely, give nothing by mouth and call your local emergency number (112 in Türkiye and across the EU).

Preventing low blood sugar

• Do not skip meals; with insulin or glucose-lowering tablets, keep mealtimes regular.
• Ask the doctor in advance how to take medicines when appetite drops or with vomiting or diarrhoea (a “sick day plan”).
• Alcohol and strenuous exercise make low blood sugar more likely.
• Record readings with the time; frequent low values may mean the dose needs adjusting.
• Keep fast-acting sugar by the bed, in the bag and somewhere the caregiver knows.

Daily foot checks

Diabetes can cause loss of feeling in the feet and slow wound healing. Check the soles, between the toes and the heels every day, using a mirror if needed. Show the doctor within the week any redness, blister, crack, colour change or wound that is not healing. Wash feet in lukewarm water and dry carefully between the toes; avoid walking barefoot and never put a hot-water bottle directly on the feet. If nail cutting is difficult, ask a health professional for help.

Signs of high blood sugar

Excessive thirst, frequent urination, a dry mouth, tiredness and blurred vision can suggest blood sugar is running high. Seek medical help without delay if high readings come with vomiting, breathlessness or drowsiness and confusion, especially during an illness.

What not to forget at check-ups

• Regular eye examinations
• Kidney function and urine tests
• Foot examination
• Blood pressure and cholesterol monitoring
• A list of all medicines, herbal products and supplements for the doctor