If you or someone you love has received a diagnosis of diabetes, the first step is to learn as much as you can about the disease. Our home care team is here to help with the information you need and the hands-on assistance to better manage diabetes.
What Is Diabetes?
Diabetes is a disorder of energy metabolism. All naturally occurring foods can be used for energy, but starches and sugars (carbohydrates other than fiber) are quickly converted into glucose by the body, and available for quick energy. Proteins can also be converted into glucose with more effort. Fats can be converted into ketone bodies, which are an alternate, but slower fuel source.
A nondiabetic person will awaken with blood glucose between 80-99 mg/dl. When they eat breakfast, their blood glucose will rise to a level below 140. The pancreas secretes insulin, which will drive the glucose into body cells. The healthy person’s blood glucose levels will drop to fasting levels (80-99) within three hours. Most healthy people will feel a small increase in energy after eating, and a small decrease after three or more hours.
Insulin acts like a key that opens body cell doors, pushing glucose out of the bloodstream and into the cells. Glucose cannot enter the cells if the cells are already full of glucose. Glucose is forced to continue circulating in the bloodstream. Because persistently high glucose damages blood vessels, insulin then looks for another way to dispose of it. The liver can take glucose and convert it into glycogen, the storage form of glucose. When the liver’s glycogen stores are full, insulin then converts the excess into triglycerides, which are moved into fat storage.
What Is the Difference Between Type 1 and Type 2 Diabetes?
Type 1 diabetes is an autoimmune disorder, frequently genetic, and diagnosed in younger patients. Because the pancreas produces little or no insulin, glucose cannot enter cells, the liver, or fat storage normally. Type 1 diabetics may be very thin until they are treated, typically with insulin injections.
Type 2 diabetes is an acquired disorder. People can be genetically predisposed to it, or acquire it over time, especially if they eat a high carbohydrate diet and are overweight. The pancreas secretes insulin, and insulin knocks on cell doors, but the cells are either already full of glucose or are “resistant” to insulin’s knock. If this happens repeatedly, more and more insulin is required to do the same job. (Think of an alcoholic requiring more and more alcohol to feel intoxicated.) At this point, a person is considered “insulin resistant.”
Both type I and type 2 diabetics may have unstable blood glucoses related to diet, infrequent blood glucose checks, or improper use of medications.
What Causes Unstable Blood Glucose?
High blood glucose (hyperglycemia) occurs when body cells either do not allow glucose to enter cells, or already are saturated with as much glucose as they can hold, and liver stores are also full. Stress, illness, high carbohydrate diets, and many alcoholic drinks raise blood glucose and potentially increase the need for insulin. Chronic hyperglycemia can cause damage to blood vessels anywhere in the body, including eyes, the heart, and skin. Symptoms of hyperglycemia typically include increased thirst and urination, blurred vision, headaches, weakness, and extreme cravings or hunger. Unfortunately, many people do not experience symptoms, and are unaware that their hyperglycemia is dangerous.
Low blood glucose (hypoglycemia) usually occurs when too much medication is given. It is very important to test blood glucose before every insulin injection. Adopting a low carbohydrate/low sugar diet and exercising can lower blood glucose and may reduce or eliminate the need for insulin injections. However, it is not advised to make any sudden changes without more frequent blood glucose checks and doctor supervision. Symptoms of hypoglycemia typically include trembling, sweating, increased heart rate, sleepiness, confusion, and dizziness.
Hypoglycemia Is an Emergency!
Very low blood glucose, from any cause, is an emergency. If a person is alert, with glucose readings around 70 and stable or climbing, feed the person an easily digested carbohydrate source, like 4 ounces of orange juice or milk. Check their blood glucose again in 15 minutes. Follow up with a more slowly digested meal, with fiber and protein, to prevent a recurrence.
If a person’s blood glucose is below 65 and dropping, and the person appears confused and sleepy, and/or is slurring their words, you may not be able to safely feed the person anything (due to the risk of aspiration) and MUST call 9-1-1.
How Can Advantage Home Care help?
Many seniors do not check their blood glucose often enough to understand their symptoms, follow dietary advice, or take medication appropriately. Unfortunately, diabetes tends to worsen over time, and people become habituated to their symptoms. A senior with memory loss may not understand they cannot safely eat or take their medications like they did when they were younger.
At Advantage Home Care, our staff can assist those with diabetes with reminders to check their blood glucose before and after meals and before bed. We are licensed to administer or assist with medications, including diabetes control medications.
If the person is unable to check their blood glucose due to tremors or poor eyesight, ask a doctor if they can prescribe a continuous glucose monitor. CGMs are somewhat difficult to start using for most seniors. However, our staff can assist, supervised by our RN, with application and set-up. Our RN can also delegate caregivers to give insulin injections, as appropriate.
Additionally, we can shop and prepare healthy meals. We can package extras for reheating later, reducing the temptation to eat fast food or TV dinners.
We can chart vitals, including blood glucose. These charts can be useful over time to track changes in glucose levels so doctors know whether to adjust medications.
Are you concerned about a loved one’s comprehension of dietary advice and doctor’s orders? Contact us today at 541-440-0933 to see whether our services may provide you with peace of mind. Advantage Home Care proudly provides trusted in-home care services in Roseburg, Winston, Myrtle Creek, and nearby communities.