Health and Business: Care Of Older People with Diabetes

Caring for older people with diabetes requires special thought and consideration.

The older individual is more likely to have other health problems and may be taking a variety of different medications.

Firstly, knowledge of the different types and actions of the medications used in the treatment of this complex disease will aid the caregiver in preventing potentially serious complications from occurring.

Some oral medications may cause lowering of the blood sugar, while others do not. Knowledge of those medications that lower blood glucose levels will guide the caretaker in ensuring that meals are provided to person on time, and more importantly, that a minimum amount of food is eaten.

The meal should include carbohydrates or starches, such as bread, potatoes, rice, milk, or fruit.

Adequate fluid intake is also important in older people with diabetes.

Often a person in a frail state will not have the energy to eat or drink by themselves, thus it becomes the duty of the caregiver to spend the time to ensure that a sufficient intake is achieved.

Hypoglycemia

Hypoglycemia, or low blood sugar occurs when the blood sugar level drops below 70mg/dl.

Symptoms that may be noticed are sweating, shakiness, nervous, irrita‐ bility, and if untreated lead to confusion and total lack of response.

An older person may not recognize or be able to verbalize the symptoms, therefore it may be the astute caretaker who notices first.

Treatment should be initiated quickly.

If possible, check the blood glucose level, and then provide 15gms of rapid acting sugar. ½ a cup of juice, 3‐ 4 glucose tablets, or glucose gel. The blood sugar level should be rechecked in 15 minutes to be sure that it has risen above 70mg/dl.

Depending on the person’s treatment regimen, a small snack may be necessary to make sure the level does not drop again.

Hyperglycemia

Hyperglycemia, or high blood sugar, occurs when the blood sugar levels rise above 200mg/dl.

Blood sugar levels may rise after meals, and that is normal, however as levels begin to rise symptoms may be present.

Symptoms of a high blood sugar include, thirst, frequent urination, tiredness or fatigue, hunger and also irritability.

This can lead to coma if untreated. Common causes of high blood sugar are eating too many carbohydrates, not enough medication or missed doses of medication. Infection or stress may also cause elevation of blood sugar levels.

Care of Older People with Diabetes

HHNK

HHNK or Hyperosmolar Hyperglycemic Non-Ketotic coma can arise in older people with type 2 diabetes, if infection and severe dehydration are present.

Symptoms include extreme confusion and loss of consciousness.

Blood sugars can rise above 1000mg/dl! Immediate hospitalization is required to reverse this emergency state.

Foot Care

Foot Care is an important aspect of diabetes care, especially in older people since they are often unable to perform the simple tasks such as nail care themselves.

With long standing diabetes, loss of sensation and feeling in the feet is often present.

Pain, normally associated with injuries of or to the feet, may be absent.

Regular inspection of the feet, checking between the toes for athlete’s foot (fungus), looking for cuts, sores or injuries is very important, and should be performed daily with the daily bathing routine.

Services of a Podiatrist for regular nail care should be sought to prevent ingrown toe nails, and also for care of calluses or warts. “Bathroom surgery”should never be attempted by family members of those with diabetes.

Foot infections can go quickly to the bone, leading to osteomyelitis.

This condition is treated promptly by I.V. antibiotics and may in unresponsive cases, lead to amputation.

“Older people with diabetes require special thought and consideration. “

Exercise

Exercise is important for older people with diabetes, whether that be short walks as able or chair exercises under supervision.

Exercise helps utilize glucose taken in the diet and mobility also increases feelings of self worth.

Older people should be encouraged to engage in group activities where possible, and to perform self care as long as they are able.

Helping those we love live healthier lives...