2023-09-15 22:04:04
Life expectancy is increasing – this also applies to people with diabetes. However, insulin treatment in old age often represents a challenge for those affected and their relatives. How can they organize help?
Thanks to improvements in the quality of care, people with diabetes are living longer and longer. But this good news also means that more and more of them will need care as they age. A major challenge for those affected and their families. “Decreasing blood sugar levels and discomfort in the feet and legs, poorer vision, increased thirst or frequent urination can be signs that a relative with diabetes needs support due to age-related limitations,” says Dr. Matthias Riedl, diabetologist, nutritional doctor
and medical director of the Medicum Hamburg. “Even if you notice that medication is being taken irregularly or that the person concerned is gaining or losing weight quickly, you should pay attention.”
Discuss, control
Those affected and their relatives should consult with each other, with their family doctor, the diabetes team and all other professional groups involved in the care regarding care measures. The German Diabetes Society (DDG) noted in a guideline in 2018: Therapy for older people with diabetes should primarily be regarding maintaining quality of life and avoiding hypoglycemia. The HbA1c value therefore plays a smaller role in older age.
Help from relatives
The assistance goes beyond support with blood sugar testing and insulin injections. “Nursing relatives should ensure that the affected person eats a healthy diet in order to avoid severe fluctuations in blood sugar. It is just as important to keep up with doctor’s appointments and check-ups as well as – if possible – regular exercise,” says Riedl. For insulin therapy, Riedl recommends CGM devices that continuously measure glucose using a sensor. “The diabetes team can track the blood sugar curves via a cloud,” he explains. “Many sensors also emit an alarm in the event of impending hypoglycemia or hyperglycemia, so that you can react quickly.” Practical: Some CGM devices offer a follow-up function that also allows relatives to keep an eye on blood sugar on their smartphone.
To ensure that relatives feel confident in what they are doing, training in a diabetes-focused practice helps. Riedl: “The training courses cover, among other things, the interpretation of blood sugar values, the functions of the insulin pump, reading measuring devices and injecting insulin.” If relatives can no longer provide care, they should call in a nursing service for daily diabetes management.
The DDG has introduced further training for diabetic nurses to ensure comprehensive, guideline-compliant diabetological care. “The treating doctor can issue a care prescription, which must be submitted to the outpatient care service, which takes care of planning and billing with the health insurance company,” explains Riedl. “Information regarding outpatient nursing services can be found through recommendations from your family doctor or diabetologist, and the nursing insurance fund can also provide a list of regional nursing services.”
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