DIABETIC CARE

Some people with Diabetes need special care.  These are usually the elderly and children.  They need someone to help them manage their diabetes. 

Children with diabetes normally have Type 1 and need to inject regularly.  Injections need to be taken at the correct times and the correct dosage has to be given as well.  Children need to eat the correct amount of carbohydrates at given times throughout the day.  Exercise will help to lower the blood sugar level.  Stress or illness will cause the blood sugar to rise.

Older people normally manage their diabetes well.  The problem arises when an older person falls ill with a disease e.g. Dementia.  They will now require extra care and support so that the situation can be managed.

By managing their disease, the patient will feel in control of their disease.  Often with the prognosis of diabetes, depression sets in and the patient feels overwhelmed with the situation.  It is imperative to know the level of your blood sugar.  Your blood sugar can be measured at home by using a test kit which can be bought at any leading pharmacy.  They are accurate and user friendly.

There are however a few simple steps needed to be taken to ensure an accurate reading:

  • Choose the correct spot to prick yourself – finger, thigh or upper arm;
  • Consult your doctor on the appropriate time to prick yourself;
  • Have a plan if your blood sugar levels are too high or too low;
  • Keep a record of all your readings.

With diabetes it is important to monitor your weight. 

By losing weight one can lower your blood sugar level.  The advantages of weight loss are:

  • Blood sugar is lowered;
  • Blood pressure is reduced;
  • Cholesterol levels will improve;
  • Less stress on feet or joints;
  • Gain more energy and breathe easier.

 

Start an exercise plan and eat a healthy diet. 

There are various foods that control blood sugar.  One should eat foods with the correct type of carbohydrates as well as the correct amount of carbohydrates.  There are seven foods that will help regulate your blood sugar:

  • Low carbohydrate vegetables e.g. Brussel sprouts, —–, onions, brinjals, tomatoes and mushrooms. May be eaten raw, cooked or roasted;
  • Green leafy vegetables e.g. —-, spinach and chard;
  • Low calorie drinks; Infuse water with vegetables (cucumber) and fruit (strawberries);
  • Berries or melon; One cup of berries has only 15g of carbohydrates. They are packed with nutrition and fibre;
  • High fibre, wholegrain foods e.g. legumes (lentils, peas, beans)
  • Some fat; Use olive oil or avocado oil. Eat fatty fish e.g. salmon;
  • Eat lean meat, eggs, cottage cheese and Greek yogurt.  Eat peanut butter on a piece of celery as a healthy snack.

nurse with grandma 

Living with diabetes, the more active you are, the better for you. 

Diabetes affects your eyes, skin, teeth and more.  Glaucoma and cataracts may show up earlier if you have diabetes.  This is an important reason to keep taking precautions to keep your blood sugar under control.

 

Diabetes in people older than 60 may cause you to develop diabetic retinopathy.  There are 2 types: –

  1. NPDR (non-proliferative diabetic retinopathy)

This is the earliest stage and causes blurred vision but not blindness.  The retina’s blood vessels leak fluid into the macula.  This results in swelling the macula and it is called macular oedema.  This condition will improve once your blood sugar reaches an acceptable level.  Lasers and injections are also used to improve this condition. 

  1. PDR (proliferative diabetic retinopathy)

This is the advanced stage.  The retina is deprived of blood because the vessels dry up.  To compensate for the loss of blood supply, the retina creates new, weak vessels which are abnormal.  The break easily.  This causes more severe loss of vision than NDPR.

 

Diabetes also affects your teeth.  The following conditions occur with diabetics:

  1. Gingivitis

Bacteria causes bleeding and redness of your gums.  When your blood sugar is high, your saliva has a higher sugar content and the bacteria feeds on the sugar and thrives.  The bacteria produce tooth decay which leads to tooth decay.  It is therefore imperative to brush, floss and rinse with an antiseptic mouthwash regularly. 

  1. Periodontitis

Gingivitis can lead to periodontitis.  The bone and tissue which support your teeth is eroded.  You may lose your teeth as a result.  Brushing and flossing will not cure periodontitis.  A specialist will have to perform gum surgery to save your teeth.

 

For women going through menopause it is important to test their blood sugar levels. 

The reason being is that the symptoms of menopause and diabetes are similar:

  • Dizziness
  • Irritability
  • Sweating
  • Lack of concentration

As men get older their testosterone levels drop.  This can result in insulin resistance.  The blood sugar levels can be improved with testosterone therapy.

 

Some people also suffer with diabetic nerve pain, which is also called diabetic neuropathy. 

The nerves, especially in your feet and legs are affected.  They pain because the high blood sugar level harms the nerve fibres.  This condition affects 60 – 70% of people with diabetes.  There are 2 types of neuropathy i.e. peripheral and autonomic neuropathy.

  1. Peripheral Neuropathy

It is the most common form of diabetic joint pain.  It affects your arms, hand, legs, feet, fingers and toes.  With ongoing diabetes, joints can no longer respond like they should to the strain and stress placed on them.  As a result, small fractures called micro fractures occur.

The symptoms, which are usually worse at night, are:

  • Numbness
  • Less sensitivity to pain and temperature
  • Tingling
  • Burning
  • Sharp pains
  • Cramps
  • More sensitivity to touch
  • Loss of reflexes
  • Muscle weakness
  • Loss of balance and coordination
  • Foot problems like ulcers and infections
  • Wasting of muscle in hands and feet

 These symptoms are largely feelings or sensations.  They are different from the outward changes that come with regular joint pain. 

  1. Autonomic Neuropathy

It affects the part of your nervous system that controls your heart, lungs, bladder, digestive tract, organs and eyes.  It goes after your blood vessels and increases blood flow to your limbs resulting in swelling and weakened bones.

 Symptoms are:

  • Bladder problems, incontinence and urinary tract infections
  • Constipation
  • Diarrhoea
  • Nausea and vomiting
  • Trouble swallowing
  • erectile dysfunction in men
  • vaginal dryness in women
  • increased or decreased sweating
  • sharp drops in blood pressure
  • increased heart rate

[http://www.webmed.com/diabetes/diabetes-care-home]

 

A few tips for caregivers would be the following:

Education about diabetes is essential.  Someone with diabetes can life a long and healthy life provided that it is managed.  The diagnosis needs to be absorbed.  It takes time to come to terms with the prognosis of diabetes.

Encourage the person with diabetes to self-care.  Be careful not to nag or create a stressful atmosphere.  Changes can be made together e.g. start exercising together.  Work out a healthy diet with the help of a professional.  Most importantly know that diabetes can be managed successfully.

 

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