【予防必須】高齢者と糖尿病
糖尿病は、若年者であれ、高齢者であれ非常に怖い病気であることをご存じですか。なぜ糖尿病が怖い病気なのか、今回は高齢者の糖尿病についてスポットを当て、病気についてと予防法まで、ここでまとめています。
目次
糖尿病について、思い出しましょう
糖尿病は、すい臓から分泌されるインスリンが充分でなかったり（インスリン分泌不全）、インスリンが作り出されていても、十分に作用しないといった状態（インスリン抵抗性）になり、体内へ、充分に糖を取り込むことができなくなるのが「糖尿病」です。
糖尿病は1型糖尿病・2型糖尿病と、全糖尿患者のうち、1型糖尿病は5％を占めると言われ、小児～思春期である10代のうちに発症することが、多いとわかっています。自身のインスリンを作る機能が壊れてしまっている状態が1型糖尿病です。一方2型糖尿病は血液中のブドウ糖が増えてしまった状態です。2型糖尿病は、最も一般的な糖尿病です。その理由は、0人に9人以上が、2型糖尿病だと言われているためです。若い人でも発症する場合もありますが、40歳を過ぎてから発症することがほとんどです。中高年に多く、生活習慣によるものです。自覚症状を感じづらく、発見されるころには重症になっている場合もあります。糖尿病になる原因はさまざまなものがあり、食生活や遺伝の体質、環境と言った組み合わせで起こることが、分かっています。
糖尿病の合併症について知りたい！糖尿病が怖いと呼ばれるワケ
糖尿病になり、糖を細胞の中に取り込むことができなくなると、血糖が高い「高血糖」の状態が続き、血管を傷つけてしまいます。それが原因で、身体のさまざまな部分で、「合併症」と呼ばれる、身体の異常が起きてしまいます。
合併症には次のような症状があり、糖尿病の三大合併症と呼ばれています。
・糖尿病神経障害⇒糖尿病になり、常に濃い糖が血管を巡ることで、神経が障害を受けます。すると、感覚の低下、下痢や便秘、足のしびれといった症状を発症することがあります。
・糖尿病網膜症⇒目の網膜と呼ばれる部位に負担に負担がかかってしまうことで、毛細血管はもろくなります。毛細血管に「こぶ」が出来たり出血したりする症状です。
・糖尿病腎症⇒腎機能が弱まること、からだがむくんだり、気分が悪くなったりすることがあります。腎臓の機能が極度に悪くなると、特別な治療(透析)を、定期的に永続的に行わなくてはなりません。
また糖尿病が引き金となり、心筋梗塞や脳梗塞といった病気につながることがあります。
糖尿病は完治が難しい病気で、慢性疾患の一つです。一度発症すると、一生付き合わなくてはならないと言われており、怖い疾患であることがわかります。
なぜ、高齢者がが糖尿病になりやすいのか
老化により筋肉が低下したり、心臓の機能や呼吸の機能が低下することと同様に、すい臓の機能も低下してしまいます。すい臓は、血糖を下げるホルモン「インスリン」を分泌します。しかし、すい臓の機能の低下より、インスリンの分泌が減り、血糖値が下がりにくい状態になってしまいます。結果、糖病病になります。
健康な状態であれば、運動することで血液中の糖分が筋肉から取り込まれて行くといわれています。しかし、高齢になると、運動をする時間も減り、筋肉量も減るため、血糖値が下がりづらい状態になると言われています。他にも、インスリンの働きの邪魔をする内臓脂肪が増えことがわかっており、血糖値を下げるためのインスリン効果が減少することが原因だと言われています。
高齢者が糖尿病により、どのようなことが起こるか
高齢者が糖尿病になり、糖尿病の内服薬や注射薬を使用した場合に、次のようなことが起こり得ます。
①低血糖の症状が出にくい
糖尿病の場合、内服薬や注射を投与することで、血糖をさげる治療を続けていきます。ところが、治療を開始したばかり方や、治療がうまくできていない方に、これらの薬が効きすぎてしまう「低血糖」の症状が見られることがあります。高齢者は、薬を一部分解する、腎臓や肝臓の機能が低下することから、血糖をさげる薬が異常に効いてしまい、低血糖になってしまうことがあります。しかも、低血糖の状態に気づきづらいのです。人間の脳は、糖で動いていますから、長時間血糖が下がった状態になると、うまく活動することができなくなってしまいます。
②治療薬の管理が難しい。
糖尿病の薬は、食事直前に内服するものや、1日1回注射するものなど、飲む時間や投与する時間がしっかりと決められていることが多くあります。この時間を誤ることで、薬の効果が得られないばかりか、血糖を必要以上に、下げてしまう場合があります。
他に既往症がある方は、なおさらそのリスクがあり、内服薬も多くなってきます。
糖尿病ばかりか、他の既往症についての管理も、できなくなることが考えられます。
糖尿病は食事、運動、薬をしっかり管理することで血糖値が安定します。しかし、高齢者の場合、認知機能が低下している人も多く、決められた食事や運動、薬をのむことができないこともあり、症状が悪化しやすくなります。
③症状のコントロールが困難である
糖尿病の症状を悪化刺さないためには、治療薬を内服・治療することはもちろん、運動や食事と言った生活も、大切になってきます。高齢者の方には、体力や意欲の低下により、継続した運動を行えない、自炊が億劫になり、インスタントやスーパーのお惣菜ばかりになってしまうなど、生活の変化による、症状のコントロールが難しくなると言われています。
④臓器の機能低下により、糖尿病の症状が悪化する
加齢により、肝機能、腎機能も機能が低下すると言われています。
血糖を下げるための内服薬を、継続して内服することで、低血糖になるリスクがあるといわれています。
糖尿病にならないようにするためにはどうしたらいいの？
高齢の場合、例え糖尿病を発症していても、自覚症状を感じづらいことから、発見が遅くなってしまうことがあります。健康診断を定期的に受け、採血データ等で、血糖値などの糖尿病の診断に関わる項目をチェックすることが、大切です。また習慣的に、体重や血圧の測定も行い、平均的な値を維持できるように努めます。
特に高齢者は、臓器の機能低下などから、糖尿病を発症した場合、他の疾患も併発しやすくなると言われています。そのことから、糖尿病を予防することで、他の疾患に罹りづらくなるとも言えます。次のような点に注意し、糖尿病の予防策を取ります。
食事編
・食べすぎを防ぐことから、一食分の食事量を決めましょう
・栄養バランスを考慮し、脂分塩分を調整します。カロリーや塩分調整がされた宅配食もおすすめします。
・いままで食べていた量を急激に減らすのは、難しいかもしれません。
1品残すことや、普通盛りのご飯を小盛りにするなどの工夫をします。
運動編
・糖尿病は筋肉量の低下につながり、また筋肉量の低下は糖尿病のリスクを高めると言われています。ウォーキングやヨガなどの取り組みやすい運動から始めましょう。
・運動は週に3～5回は少なくとも行い、20～60分間行持続できる競技にしましょう。
まとめ
加齢により機能が低下した、臓器や筋肉のために、高齢者は糖尿病にかかり易いと言われています。また、糖尿病を発症していても、高齢者の場合、自覚症状に気づきづらいこともあるため、糖尿病が進行してから発見される場合があります。未然に糖尿病を防ぐためにも、食事の工夫や運動を継続的に行い、定期的な健康診断を受けることが、大切です。
独居の高齢の家族の食生活など、心配事はありませんか？ささいな不安や悩みも一度ご相談ください。
「今後の生活環境が変わる事への不安」や「介護を使って生活をどうデザインをしていったら良いか」など介護は協力体制で成り立っております。 ちょっとでも解決できる、ストレス軽減できる記事を目指し、一つの相談場所のメディアを目指しております。
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