As a caregiver you are an essential part of the team to assist and help someone with diabetes take control over his/her condition.
Diabetes care is more than just taking care of the disease. Encouragement and support are needed so that the person in your care is able to live a better quality and productive life.
As a caregiver it is important to have a better understanding of diabetes and its serious consequences and to learn some skills on the management of diabetes.
One of the basic things to learn as a caregiver is to be able to recognise the symptoms that may require immediate attention.
Hypoglycemia (low blood glucose)
Symptoms: Shakiness, sweating, weakness, dizziness, irritability, hunger, headache, mood swing, staggering gait.
What to do:
- Check blood glucose to confirm; give a glass of fruit juice or 3 to 4 teaspoons sugar in water. Keep some sweets like a bar of chocolate if symptoms occur.
- Repeat the above measures in 10 to 15 minutes if blood glucose level is still below 4.0 mmol/l.
- If symptoms persist or extreme confusion exist, seek immediate medical attention or call for an ambulance.
Hyperglycemia (high blood glucose)
Symptoms: Thirst, fatigue, frequent urination, drowsiness, blurred vision
What to do:
- Check blood glucose
- Check urine for ketones if blood glucose is over 240 mg/dl (> 13 mmol/l)
- Continue to drink plenty of water
- Seek medical attention if symptoms persist.
Diabetic ketoacidosis (DKA) or diabeteic coma is a life-threatening condition that develops when there is too little insulin in the body. Without insulin, the body cannot use glucose (sugar) for energy instead it begins to break down fat and protein for energy. In the process, toxic acids are produced known as ketones. Untreated diabetic ketoacidosis can be fatal.
Symptoms: Abdominal pain, nausea, vomiting, extreme drowsiness, rapid breathing, flushed skin, sweet fruity odour to breath
What to do:
- Check blood glucose which is usually above 15mmol/l.
- Check urine for ketones. Urine dipstick tests for ketones are available for home use.
- Call doctor/ambulance immediately or bring him/her to the A&E department.
Important Aspects of Care
Checking Blood Glucose Level
One of the areas that you can assist as a caregiver is monitoring the blood glucose level. This will require skill on how to do a blood glucose test at home using a glucometer. When purchasing a glucometer, check with your doctor or diabetes nurse educator on the type of glucometer that is right for the person with diabetes.
Please remember the following when helping to take a blood sample by finger prick method.
- Wash your hands thoroughly before doing the test.
- Ensure the person’s hand is clean. You may rinse the hands in lukewarm water and then dry to improve circulation for a better sample.
- Do gentle massage of the hands before pricking the finger to improve circulation.
- When pricking the finger, use the side of the fingertip rather than the front top because it’s less painful.
- Apply gentle pressure on the finger pad with the sides push out to get a better sample.
Follow your family doctor’s advice on the frequency of home blood glucose monitoring that is required for the person under your care.
As a caregiver, ensure that healthy eating habits are practised. Be aware of variations in the diet and learn how to adjust the diet based on the meal plan as recommended by the dietitian. Help the person in your care to choose food wisely and encourage a well balanced meal. Consult the dietitian or doctor for problems difficulties in managing the diet.
- Use My Healthy Plate as your guide in planning the meal(s). Provide a variety of food from the four food groups.
- Keep meals regular
- Be mindful of the portion sizes when preparing or serving food
Know the benefits of physical activity in lowering blood glucose level. Physical activity not only helps in the control of diabetes but also improves blood circulation, strengthens the heart and reduces the risk of cardiovascular disease such as heart attack and stroke. Assist the person in your care to realise the importance of physical activity and ensure that it is regular.
Be also mindful of the possible risks when engaging in physical activity such as hypoglycaemia (low blood glucose). Know the signs of hypoglycaemia such shakiness, dizziness, hunger, or weakness. Remember to bring sweets or fruit juices every time.
Most persons with diabetes also have other medical condition(s) such as high blood pressure, high blood cholesterol level, and may be on medication for such problems. Know what medication(s) that the person under your care is taking and understand how it works and the potential side effects. Inform the doctor immediately if the person experiences any reaction to the medication(s).
As a caregiver, ensure that medications are taken or given (in the case of insulin injection) on time and regularly as prescribed by the doctor. Some people with diabetes are afraid of insulin injection causing rejection or non-compliance in their treatment. Helping them to overcome their fear is an important role that you can do.
Taking Care of the Feet
Foot care is very important in persons with diabetes. The person with diabetes may develop foot problems arising from either nerve damage, also called neuropathy, or poor circulation. When sensory nerves are damaged, feelings are lost and he may be unaware of a wound or breakdown of skin that can lead to infection. Diabetic foot ulcers are serious because they do not heal well resulting in gangrene which can lead to amputation.
It is important to keep the blood glucose level under control to minimise the risk of foot problems. As a caregiver, ensure that you assist in the care of the feet every day.
- Wash and inspect feet daily and seek medical care if you spot a problem
- Look for changes in skin colour, or feeling
- Gently rub skin lotion over the feet, but not between the toes
- Trim toenails straight across and file the edges
- Protect feet from extremes of temperature
- Let him use proper and comfortable footwear at all times
- Bring him to the doctor at least once a year for foot assessment and more often if foot problems arise
Helping A Person with Diabetes
A person with diabetes is faced with many challenges to keep the condition under control. Diabetes care is a team effort that goes beyond treating the disease. Family and friends support plays an important role in improving the quality of life.
A person with diabetes may face more and more stress as incapacity due to old age and other medical conditions set in. Therefore, the role of the caregiver becomes even more important in the delivery of care.