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Type 1 Diabetes in Older Adults: What You Need To Know

Medically reviewed by Sarika Chaudhari, M.D., Ph.D.
Written by Torrey Kim
Posted on August 22, 2024

Because type 1 diabetes often develops in childhood, many people don’t realize they can be diagnosed with this condition as an adult. However, getting a type 1 diabetes diagnosis after the age of 18 is more common than many people think.

“I got diagnosed with type 1 diabetes in November 2023 — I was 57,” one myT1Dteam member wrote. Another said, “I was diagnosed 10 years ago at 57. What a roller coaster.” A third member wrote, “I’m almost 60! I was diagnosed with type 1 in September 2021.”

Even for those diagnosed with type 1 diabetes as children, it’s important to know what life with type 1 diabetes might be like later in life. Check out some facts about living with type 1 diabetes as an older adult, and how to manage the condition.

Can Older Adults Develop Type 1 Diabetes?

Type 1 diabetes can develop at any age. In fact, about 50 percent of people diagnosed with type 1 diabetes are adults. Some of these diagnoses may occur among those who had the condition as children but weren’t diagnosed until after they turned 18. But researchers say that adult-onset type 1 diabetes is even more common than childhood-onset.

Adults with type 1 diabetes are often misdiagnosed. One study found that about 38 percent of people over 30 who had diabetes symptoms were treated for type 2 diabetes and not given insulin when they actually had type 1 diabetes.

Such misdiagnoses occur for several reasons. First, many people don’t realize that type 1 diabetes can begin after childhood. Additionally, the condition causes different symptoms in adults compared to children.

For instance, children with type 1 diabetes experience insulin reductions so quickly that their blood glucose levels skyrocket. The symptoms that follow are serious and typically require daily insulin as treatment.

Adults, on the other hand, tend to make more insulin than children, which means they may have more reasonable blood sugar levels. This can lead health care providers to incorrectly diagnose adults with type 2 diabetes instead of type 1 diabetes.

“I was diagnosed with diabetes when I was 38, but I was told it was type 2,” one myT1Dteam member said. “Since then, I have had numerous medications and different therapies prescribed to get it under control and nothing was working. My blood sugars were still high and dropped low, and my A1c never went down. Luckily, when I was finally referred to an endocrinologist, she ordered a C-peptide test, which determined that I was not a type 2, but a type 1.”

Type 1 diabetes is an autoimmune condition. This means the body attacks the part of the pancreas that makes insulin. Type 2 diabetes, on the other hand, is caused by lower insulin production and insulin resistance (low response to insulin). These conditions are managed differently. That’s why it’s important to get an accurate diagnosis from the beginning whenever possible.

The Challenges of Managing Type 1 Diabetes as You Get Older

Whether you were diagnosed with type 1 diabetes when you were young or you developed it as an adult, you must keep certain factors in mind to stay healthy as you get older. As people with type 1 diabetes age, the risk of severe hypoglycemia (low blood sugar) rises.

Hypoglycemia can cause health problems, including:

  • Shakiness
  • Anxiety
  • Confusion
  • Sleepiness
  • Dizziness
  • Weakness
  • Hunger
  • Increased heartbeat
  • Sweating
  • Blurred vision
  • Headaches
  • Seizures

Similarly, hyperglycemia (too much blood sugar) can lead to:

  • Heart disease
  • Kidney problems
  • Stroke
  • Damage to the legs or feet
  • Vision issues like retinopathy — a condition where the blood vessels in the retina are damaged, potentially leading to vision loss

Researchers in the U.K. studied the effects of type 1 diabetes on the health of more than 400 people who’d had type 1 diabetes for more than 50 years. They found that some of the complications of the condition included:

  • Challenges managing their changing insulin requirements
  • Issues with decision-making in terms of how to manage their diabetes
  • Difficulty in planning meals and physical activity
  • Cognition challenges (difficulties with thinking, understanding, or remembering) that make it harder to recognize low blood sugar and manage it safely
  • Mental health issues, such as depression
  • Impairments with vision, hearing, and other functions
  • Difficulty keeping track of medications for diabetes and other co-occurring conditions
  • Increased risk of falls and resulting injuries

It’s important to meet with your endocrinologist or other health care provider frequently as you get older. They can help you navigate your changing insulin therapy needs and help reduce diabetes complications as you age.

Staying Healthy With Type 1 Diabetes as You Age

The effects of type 1 diabetes on your body, along with the common health effects of aging, may require you and your caregiver to adapt your lifestyle. Consider the following as you determine what might be the best route for you:

  • Remain active.
  • Stay on top of hearing and vision care.
  • Simplify routines to navigate cognition challenges.
  • Protect your mental health.

Remain Active

Physical activity can help you reduce some of the complications that may accompany type 1 diabetes as you get older. For example, exercise can help you stabilize high blood pressure, which may reduce your risk of developing complications from diabetes. It may also help you improve your insulin sensitivity, cholesterol levels, and mood.

If you’re nervous about working out as you age, consider low-intensity exercise like walking, yoga, or dancing. You can also work with a physical therapist on age-appropriate exercises, or consider joining exercise programs in your community.

Work with your doctor to ensure your insulin levels remain stable during exercise. They can advise you on whether it might be a good idea to lower your insulin doses before working out.

Stay on Top of Hearing and Vision Care

If your vision is affected by your diabetes, you may not be able to choose the right dose of insulin, and you can put yourself at risk of falling. Plus, diabetes can lead to hearing issues, which may prevent you from hearing what your provider advises about your care. Losing your vision or hearing can also have social implications, preventing you from interacting with others and affecting your quality of life.

You can stay in control of these issues by ensuring you see experts who can monitor your vision and hearing. It’s also a good idea to control your blood sugar. An effective diabetes management plan can help you prevent some of the sensory complications that may come with diabetes and aging.

Simplify Routines To Navigate Cognition Challenges

If you have type 1 diabetes, you’re at an increased risk of cognition issues compared to those without diabetes. In addition, the combination of aging and diabetes leads to a higher risk of developing dementia.

People with type 1 diabetes should get screened for cognition issues as they age. It’s also a good idea to work with your diabetes care team to simplify your routines, which can help you manage your insulin intake and other issues. If needed, work with an occupational therapist who can help you cut extra steps out of your daily routine to make it easier to follow.

Protect Your Mental Health

Depression is common among adults with diabetes. Being depressed can cause you to stop managing your insulin intake, eating properly, or exercising as much as you should, which could affect your insulin levels.

Stay on top of your mental health by talking about your feelings with your health care team. They can put you in touch with a counselor, advise you on ways to improve your mood, and check whether your medication levels may be affecting your mental wellness.

Talk With Others Who Understand

On myT1Dteam, the social network for people living with type 1 diabetes and their loved ones, more than 3,500 members come together to ask questions, give advice, and share their stories with others who understand life with type 1 diabetes.

Were you diagnosed with type 1 diabetes as an older adult? How did it affect your diabetes treatment plan? Share your experience in a comment below, or start a conversation on your Activities page.

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