According to the American Diabetes Association, more than 29 million Americans have diabetes, and sadly, the number keeps rising. As the general population gets older, the incidence rate of diabetes (diagnosed and undiagnosed) continues to increase: “The percentage of Americans age 65 and older remains high, at 25.9%, or 11.8 million seniors” according to the ADA. This is a significant portion of the population, and it’s very likely that someone you know personally will suffer from diabetes. Let’s take a closer look at this disease, who it affects, and whether in home care is appropriate in certain cases.

What are the basics of diabetes? What’s the difference between Types 1 and 2?

Diabetes refers to the amount of glucose (sugar) in your system, and how your body produces or uses insulin. Insulin is a hormone created by your pancreas that transfers glucose from your blood into your cells. If your body does not create any or enough of this hormone, then the amount of glucose in your blood may increase to unhealthy levels, and this can have serious ramifications. For instance, your cells may initially be starved of energy (since glucose is staying in your blood instead of transferring into cells), and over time, your eyes, kidneys, heart, and other vital organs may be negatively impacted. One hopeful note, however, is that diabetes symptoms can generally be controlled with exercise and diet, which can positively affect other aspects of your life as well.

In Type 1 diabetes, the body does not produce any (or enough) insulin, which is why it is sometimes called ‘insulin-dependent’ diabetes. Type 1 is much rarer than Type 2, and is most often diagnosed in children or young adults (it’s sometimes called ‘juvenile diabetes’). Those with a diagnosis need to replace insulin through syringes, pens, or other means. Here’s what the ADA has to say about Type 1 (which accounts for roughly 5% of diagnosed diabetes cases):

• “A diagnosis of Type 1 diabetes means your pancreas is no longer capable of producing insulin. Through multiple daily injections with insulin pens or syringes or an insulin pump, it will be up to you to monitor your blood glucose levels and appropriately administer your insulin. You will need to work closely with your healthcare team to determine which insulin or insulins are best for you and your body.”

Type 2 diabetes, on the other hand, means that your body isn’t properly using the insulin that it does create. Unlike Type 1, it can be treated with insulin or with oral medications. Lifestyle changes (diet, exercise, etc) can make a big difference as well. Type 2 accounts for the vast majority of diagnosed cases – roughly 90-95% (the remaining percentage is gestational diabetes, which is outside the scope of this discussion…but click the link to learn more!). Here is what the ADA shares about Type 2:

• “Some people with type 2 can control their blood glucose with healthy eating and being active. But, your doctor may need to also prescribe oral medications or insulin to help you meet your target blood glucose levels. Type 2 usually gets worse over time – even if you don’t need medications at first, you may need to later on.”

What are the symptoms?

Someone may show all or some of the symptoms below, which should warrant further investigation. In some Type 2 cases, however, the symptoms may be so subtle that they go unnoticed for a long time. The ADA lists typical symptoms as:

• Urinating often

• Feeling very thirsty

• Feeling very hungry – even though you are eating

• Extreme fatigue

• Blurry vision

• Cuts/bruises that are slow to heal

• Weight loss – even though you are eating more (type 1)

• Tingling, pain, or numbness in the hands/feet (type 2)

Who is affected most by diabetes?

The American Diabetes Association states that African-American, Latino, and Asian-Americans/Pacific Islander populations have the highest incidence rates. Someone is also likely to develop Type 2 diabetes if they previously had gestational diabetes. As a general rule, the older someone gets, the more likely they are to develop Type 2 diabetes as well.

Why would someone with diabetes require special needs care?

For many people, managing diabetes is a learned behavior and can be accomplished without assistance. For others, however, this is not always the case. Examples might include someone who is homebound, not physically capable of caring for themselves, or someone who is too old or young to manage and prepare meals and medication administration by themselves. 

In these cases, it can be helpful to have a trained caregiver on hand, especially one who can recognize subtle signs of distress or change. Someone who is trained in special needs care for diabetics will know to look for some of the conditions commonly associated with diabetes, like

• hypertension

• depression

• coronary artery disease

• respiratory diseases, and more.

A trained caregiver can recognize and address these comorbidities, as well as assist with general diabetes management. Dehydration is also commonly linked with diabetes, as well as the potential for malnutrition or sporadic intake of food, or neuropathies, especially as the person gets older. Registered Nurses, Certified Nursing Assistants, and Home Health Aides will likely be able to recognize and address these potential problems sooner than a family member or an untrained eye could.

Someone with a healthcare background can assist diabetic patients with medication management, preparing nutritionally-balanced meals, and helping with exercise and/or an active lifestyle. For these reasons, special needs care might be an appropriate next step.

Do you or someone you know need assistance with diabetes management? Contact PAN today to see how we can help!