Diabetes is a common disease characterized by an inability to efficiently produce or respond to insulin production within the body. In fact, it's so common one in three people in the U.S. is living with diabetes. While there is no cure, proper medical care along with lifestyle changes can reverse diabetes. Learn more about how diabetes affects seniors and the different long-term care options available.
Type 1 Diabetes
Type 1 diabetes occurs when the immune system begins to destroy all the cells in the pancreas that are responsible for the production of insulin. The body does not have enough insulin to be able to function in a normal way. When the body decides to attack itself, the reaction is called an autoimmune reaction. There are some events that have been isolated as triggers but it is still a bit unclear as to what the main cause might be. It can come from any of the following:
- A bacterial infection or a viral infection of any kind
- Toxins in food and water
- Strange components that cause your body to react
- Genetics may also play a role in the activation of the disease
Type 2 Diabetes
Type 2 diabetes (aka diabetes mellitus or adult-onset diabetes) is a metabolic disease that causes the sugar in your body to collect in your bloodstream. Many Type 2 diabetes sufferers only need minor lifestyle changes, like weight loss. Others who have this diabetes type require permanent therapy that involves medication and insulin. Over time, there are many factors that can lead to this type of diabetes, including insulin resistance. There are other Type 2 diabetes risk factors, here are a few:
- Obesity in the body
- Not living an active lifestyle
- Having a bad diet and not being careful what you are consuming
- Heart disease
- Illness can also have a triggering effect on this diabetes
Conditions that can worsen diabetes
- Having Pancreatitis or having a pancreatectomy can cause the emergence of diabetes.
- Polycystic ovary syndrome (PCOS) is another condition that can accelerate the onset of obesity. PCOS is a hyperandrogenic disorder (a medical condition characterized by excessive levels of androgens which are male sex hormones such as testosterone - in the female body) that is associated with a high-risk of development of Type 2 diabetes mellitus (T2D).
- Cushing’s syndrome is a disease that will increase the production of cortisol which directly increases the diabetes risk factor.
- Steroid use can also cause a rise in glucose and increase your risk of developing diabetes.
Impact on loved ones
Getting diagnosed with diabetes is a major shock, and will change the lifestyle of the patient and the family. First and foremost, family members of people with diabetes must help ensure risk factors are minimized and medical instructions and appointments are adhered to.
The diet is something that will have to be looked at and monitored very carefully. There are many people who have type 1 diabetes who must make sure that they are carefully monitoring their intake of carbohydrates to ensure that the proper levels of insulin in the blood. Your body uses insulin to turn sugar into energy. In this instance, the pancreas produces little or no insulin because the beta cells have been destroyed by the immune system.
There are also many people who have type 1 diabetes who will then take carbohydrate counting courses which will help them to learn how to manage their food intake and know what it is that they need to do. With Type 2 diabetes, the diet can really help, although it presents challenges because there are many patients that rely on the consumption of carbohydrates. From the moment that a person is diagnosed with diabetes, you must make sure that there is a careful monitoring process for food intake.
Diabetes is a disease that impacts the individual as well as family members and requires immediate changes to lifestyle. For this reason, those suffering from diabetes find it hard to admit that they have the condition. People who have diabetes must monitor their sugar intake and make sure that this is within the ‘safe’ range. Continuing to eat as one has done prior to being diagnosed with diabetes can result in negative health consequences such as the onset of blindness, nerve damage, kidney failure and many other debilitating illnesses.
Family members play an important role in supporting loved ones with diabetes. You want to be sympathetic to the diagnosis. It is challenging when these changes have to happen overnight, but.family members need to be resolute and support the new lifestyle and restrictions.
You want to make sure that you are being emotionally supportive and that you are also helping ensure that you are making changes to your lifestyle, such as eating healthier, that will lead to diabetes prevention. Do this by avoiding the foods that should not be in the house. Instead, stock up on foods that are low fat, low cholesterol, low in sugar, and low in salt. Add in lots of fruits, vegetables, grains, healthy meats, and fish. Pay particular attention to portion sizes.
Overall, make sure that you live a healthier lifestyle and with plenty of
Make sure that you know all the signs of the problems and symptom of diabetes. Make sure that you know the signs of low blood sugar. For example, if your family member is acting cranky, it may be that the blood sugar is too high or that it is too low.
High blood sugar
Hyperglycemia is the technical terms for high blood glucose level in your bloodstream, also referred to as high blood sugar. When you are with a person who becomes sick after eating too much, they may have hyperglycemia. This means that there is too little insulin in the body and that the body is stressed. High blood pressure, or hyperglycemia, symptoms include:
- Constant urination
- Heightened thirst
- Blurry vision
- Being very tired without explanation
Low blood sugar
Hypoglycemia, or low blood pressure, is when the blood sugar in your body is too low. For those with diabetes, it means you have not eaten enough and you do not have enough insulin in your body. It can also happen you have exercised too much and are physically exhausted. Here are a few symptoms that are signs of low blood sugar, or hypoglycemia:
- Yawning all the time
- Muddled speech
- Loss of coordination
- Constant sweating
- Constant twitching
- Feeling faint
- Becoming pale
- Not being conscious
Living with diabetes
It is important to note that it takes a while for people to learn how to live with diabetes. What that means is that there are going to be good days, and there are going to be bad days. When the diabetic person is under stress, there is going to be more trouble trying to control the blood sugar level.
What that also means is that you need to do what you can to help the person keep things in perspective and get back on track. You want to let them know that you are there to support them to be healthy and to live an active lifestyle.
Make sure that you take your family member to the doctor when there are symptoms of high and/or low blood sugar. These symptoms can be extreme at times and it is very important to make sure that you are focusing on them. A sudden drop in the blood sugar can indicate that blood sugar levels are dangerously low. You need to make sure you recognize the signs so you can react accordingly. Some of these diabetic symptoms are:
- Being dizzy
- Having a headache
- Having blurred vision
- Having rapid heartbeat
- Being confused
- Slurred speech
Questions to ask the doctor
You want to make sure that you take the time to find out what you can do, and there’s no better person to ask that your family physician. Here are a few suggested questions to ask:
- What type of diet is appropriate for a diabetic?
- Can my relative have sugary treats? What does ‘in moderation’ mean for my relative?
- When does he or she need to take medicine?
- How regularly does my relative need to test his glucose levels?
During any doctor consultation with your loved one, speak up, be honest and ask questions. Be clear about what you are willing to do, and not do. For example, if a meal plan looks totally unrealistic for you and your lifestyle, then speak up. There are always alternatives. Do not leave the office in silence without any intention of following the doctor’s recommendations.
Diabetes organizations and resources
When it comes to diabetes, the situation is more common than you might expect. With obesity on the rise, it is important to know where to turn to when a diabetic diagnosis has been given. One of the best resources is the American Association of Diabetes which has great online resources as well as forums that allow you to interact with other patients who have the disease.
We Are Diabetes, is another organization that helps new patients find a way to get help and to ensures that questions get answered. There are also many nonprofits and groups that can suggest local gyms and exercise programs to help with diabetes exercise. These include Convoy of Hope, Children’s Diabetes Foundation, Diabetes Research Institute Foundation (DRIF) and the Juvenile Diabetes Research Foundation (JDRF).
Managing diabetic care
In addition to finding out about dietary restrictions and plans from a medical professional, another issue that must be managed is ongoing blood glucose testing. Blood glucose testing is important to make sure that these are within acceptable levels. Work with your healthcare provider as well to make sure that you help the diabetic person keep a detailed log of these critical tests. Work with your physician to make sure that in the long-term all your medical needs are met and that if a medicine is necessary, to advise the best course of medication for the diabetic patient.
Money is a stress for nearly everyone. There are additional stressors when diagnosed with diabetes, such as the high cost of medical care and medication. If help is needed paying for care, there are a variety of government and non-government programs to help cover you.
Review the National Institute of Diabetes and Digestive and Kidney Diseases, the National Conference of State Legislatures on Medicaid and CHIP and the Centers for Disease Control. In addition, there are long-term complications that you need to address that will allow you to see how you are going to handle them and to know what you can do to alleviate some of the burdens.
It is very important when you are looking at diabetes to realize that there are legal needs that need to be addressed. Primarily, this revolves around appointing a power of attorney to take care of your personal and medical needs should you be unable to do so.
Finding the right doctor
When you find out that your family member has been diagnosed with diabetes, finding the right doctor is critical. Your physician is going to become your partner on the road to managing the diabetic condition. Take time and review all your choices, and find someone who is the right blend of experience as well as of responsibility.
There are now many to review prospective doctors online to help ensure that you are finding the right medical partner. Find out if you are able to submit your questions online or do you need to go through their automated phone system? Also, find out how quickly you can expect a response. One of the resources in the American Medical Association’s (AMA) tool for finding a doctor online.
Diabetes blogs are also good places to identify people who live in your area and who may be able to refer you to a good local doctor.
Another way is to talk to friends, relatives outside of the immediate family circle, as well as support groups to ask for physician recommendations. Doctors who work with support groups, participate in local diabetes educational
Tips for caregivers
When you care for someone who has diabetes, it is very important to make sure that you know what you are doing and that you have a plan to ensure that you are going to be working with the doctor as well as with your family member to make sure that you are caring for them as best you can. Here are 7 tips to help you along the way.
1. Educate yourself
Research the condition. Find out as much as you can from various sources on what to expect from the condition. Other than the internet, books and reputable publications, other members outside of the immediate family, especially if they have gone through or are going through the condition may be able to provide you with referrals to physicians and a heads up on what to expect. It is critical to
2. Know your limitations
When you realize that a family member has diabetes, it may be necessary to take the time to make sure that you know how to diabetes self-management care works for that person as it is a very large responsibility to all of a sudden have on your shoulders. Do you have the time and resources to take this on? Look into some care options.
3. Encourage self-care
You want to work with the diabetic patient to make them comfortable with self-care tasks. But, do not be surprised if there is some pushback, as it is going to require difficult changes to their way of life. In the beginning, you may meet resistance to your suggestions to exercise or to opt for healthier food options.
It is a huge burden to hear that one has just been diagnosed with diabetes and there may be a period of denial and the insistence that nothing is wrong. Exercise patience and understanding when this happens. Having to live with diabetes is a life-changing event.
4. Implement changes together
It is important to focus on making changes together. There’s no better way to help with recovery than to have someone by your side experience the same things as you.
5. Make small goals
In consultation with the family doctor, make small changes in the daily diet and start with just 10 minutes of walking a day, slowly increasing this over the subsequent months. The best part of this is that you don’t need expensive equipment: you can do this at home. Setting a small goal and achieving it will give you and the diabetic person a sense of satisfaction which may encourage more positive steps in the diabetic administration process.
6. Work with a care team
Make sure that you are taking classes, educating yourself, or seeking out support groups in order to help you and your loved one along the way.
7. Build your support network
It is very important to understand and to know that you are going to need your own plan and respite from managing the healthcare of a loved one. What are you going to do for yourself to ensure you can have a break?
1. How will diabetes change my life?
Diabetes will change everything about your life, from what you eat, to how you live your life. This is a good time to ensure that with monitoring and watching your diet, you will be able to take care of yourself and improve your health.
2. What type of diet do I need?
This depends on the kind of diabetes you have. This is also an opportunity to ensure that you are talking with your healthcare provider to find the best one for your situation. A high-quality diet - with fruits, vegetables, beans, whole grains, and nuts - can make it easier for weight loss rather than things like sugar-sweetened drinks, refined starches, and sugars. For example, have a low-fat yogurt with nuts (unsaturated fat) instead of crackers with cheese (saturated fat).
3. What kind of medication should I be on?
That depends on your condition. A doctor will be able to diagnose you and advise the best course of medication for you.
4. Can I get financial assistance to help defray some of the costs of diabetic care?
There are a variety of programs that can help you to cover a part of the cost of medication and care. Check out the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the National Conference of State Legislatures on Medicaid and CHIP and the Centers for Disease Control (CDC).
5. What kind of exercises should I do?
Take time to educate yourself about what you can do. Talk to your doctor to make sure that you are choosing the right exercises for your specific situation.
6. Is diabetes a common condition? How many people in the US have diabetes?
Diabetes is becoming increasingly common, with over 1 million people diagnosed in the US per year alone.
7. How can I prevent dental problems?
Keeping your blood glucose levels in check will help, as will good dental hygiene habits. Make sure you schedule a dental exam every six months.
As a guide, brush for two minutes a day with a toothpaste with an anti- gingival/antibacterial ingredient to help prevent gingivitis and one that is accepted by the American Dental Association. Make sure to contact your dentist or hygienist if you experience any of signs of gum disease such as puffy, swollen gums, pus that appears between your teeth and gums and changes in the way your teeth fit together when you bite.
Proximity of care is very important when considering options
Research care options that are nearby when thinking about the next step for your loved ones.
Leona J. Werezak RN, BSN, MN is a registered nurse and adjunct nursing professor. She has 24 years experience working in a variety of healthcare settings including such remote locations as the Arctic Circle. Her research in early stage dementia was published in the Canadian Journal of Nursing Research and re-published in their 40th anniversary issue which showcased exceptional research published since the journal began. Her work in dementia care has also been published in the Journal of Gerontological Nursing. She currently teaches surgical nursing care on a thoracic/vascular unit to baccalaureate nursing students. Her clinical work with nursing students involves extensive work with older adults who have multiple chronic health conditions.