Encouraging Short-Term Goals for Older Adults With Diabetes

 As a primary care provider, you can help patients set short-term goals to help their day-to-day lives. To begin, use patient-centered language, as this approach encourages patients to feel empowered and engaged in their own care, said Scott Isaacs, MD, president of the American Association of Clinical Endocrinology, and an adjunct assistant professor of medicine, Emory University in Atlanta.

This philosophy is especially practical if older patients in your practice have diabetes.

“Seniors with diabetes can experience symptoms and chronic conditions that can impact their daily lives. Practical strategies can make a meaningful difference in patient well-being,” he said.

An Overview of Conditions to Assist Patients

Foot pain. While you’re speaking to an older patient with diabetes, address concerns of foot pain, as when unaddressed it can lead to decreased levels of physical activity, mobility, and quality of life, Isaacs said. Patients may report tingling, numbness, burning sensations, or pain in their feet.

Scott Isaacs, MD

“These symptoms can be signs of arthritis, neuropathy, or poor circulation. It is important to acknowledge the patient’s discomfort and perform a thorough foot exam,” said Isaacs. “Recommend wearing comfortable, well-fitting shoes, keeping feet clean and dry, and advise against walking barefoot.”

Consider referrals to neurology, vascular surgery, or podiatry when appropriate.

Swollen limbs. Swelling in the legs or feet may indicate fluid retention, poor circulation, venous insufficiency, hypothyroidism, or heart or kidney problems, Isaacs said. For venous insufficiency, suggest to the patient to elevate their legs when possible. Encourage gentle movement throughout the day to promote circulation. And if swelling is new or worsening, consider further evaluation for underlying causes.

Excessive thirst. This can be a sign of elevated blood sugar levels. Evaluate glucose control and rule out diabetic ketoacidosis for patients who complain of polyuria, polydipsia, and/or blurred vision, Isaacs said.

Fatigue. True, it’s a common symptom, and while it is normal to feel tired at times, such as after exertion or insufficient rest, persistent or unexplained fatigue deserves a medical evaluation. When evaluating fatigue in older adults, reassure patients that occasional tiredness is normal, but ongoing or severe fatigue is not normal, Isaacs said.

Of note, sleep disturbances, such as poor sleep quality, insomnia, or sleep apnea, are common in older adults and can significantly impact energy levels. Also, your patient’s medication side effects should be considered, as many medications can potentially cause fatigue, he said.

Blood sugar fluctuations. Seniors with diabetes may experience symptoms of both high and low blood sugar, such as shakiness, confusion, sweating, or headaches. Educate patients about the signs of blood sugar changes. For those at risk for hypoglycemia (ie, those on insulin) recommend carrying snacks to address low blood sugar if it occurs, Isaacs recommends.

Vision changes. The American Diabetes Association recommends that all people with diabetes should have a yearly eye examination. It’s an important to make sure patients understand, said Osagie Ebekozien, MD, MPH, CPHQ, chief quality officer at the American Diabetes Association in Boston. “Blurry vision can signal blood glucose changes or eye complications. Let’s schedule an eye exam. In the short term, avoid driving if vision is poor, and keep your blood sugar in the target range.”

Why Encouraging Attainable Goals Is Effective

A primary care doctor is a valuable partner in helping older adults set short-term goals because older adults may have diverse health statuses, comorbidities, and functional abilities, Ebekozien said. Patient goal setting ensures care aligns with the patient’s unique needs.

“Doctors can also help ensure goals are realistic and safe, especially for those at risk of hypoglycemia, falls, or medication side effects,” he said. “This means addressing not only glycemic targets, but also the integration of diabetes technology, the frequency of clinical visits, and the use of relevant laboratory monitoring to optimize outcomes and quality of life.”

Encourage Patients to Self-Monitor Progress

Helping older adults with diabetes set and track their short-term health goals is a helpful way to engage and empower patients to be actively involved in their health. However, self-monitoring is not limited to blood glucose checks.

Osagie Ebekozien, MD, MPH, CPHQ

“It encompasses a range of strategies that can be tailored to each patient’s needs, abilities, and treatment plan,” Isaacs said. “Not all seniors with diabetes require daily blood glucose checks, especially those not on insulin.”

To chart progress, suggest that patients keep a simple record of meals and snacks, noting portion sizes and timing, as well as activity logs can include steps walked, minutes of exercise, or types of movement, he said.

“These records help patients have a better understanding of how their lifestyle habits impact their health,” Isaacs added.

Another self-monitoring tip is to ask patients to record blood pressure (BP) results in a notebook or digital app, even if the monitor stores the BP readings. Finally, at follow-up visits, review self-monitoring records together.

“Celebrate progress and adjust goals as needed to maintain motivation,” Isaacs said. Once you understand your patient’s daily life and priorities, you can work together to set meaningful goals that fit their situation, he said.

“Encourage patients to choose goals that feel achievable and reassure them that you are there to support them every step of the way,” he said.

https://www.medscape.com/viewarticle/encouraging-short-term-goals-older-adults-diabetes-2026a1000edr