Caring for a loved one with diabetes

As a health care provider who treats persons with diabetes, I frequently tell my patients, “I’m not the one taking care of your diabetes. You take care of your diabetes."

I say this because it’s my job to educate and provide recommendations, whereas my patients are the ones responsible for the actual work to control this disease. However, there are often times in a diabetic person’s life where he or she may need the help of a loved one. A diabetic person encounters many stages in life. Sure, it can be difficult at times, but the more prepared you are, the better you can handle the situation.

Diabetes care during the early years

I’ve known a lot of parents of children with diabetes. The news of the diagnosis of diabetes in a child can be met with fear, confusion and, sometimes, even anger. Parents need to quickly learn how to adapt to the ups and downs of this disease and are often caught off guard as they enter unfamiliar territory.   

Here are some things to remember as you care for a child with diabetes:  

• This diagnosis may mean a change in diet for your entire family.
• At first, it will feel like a moment-to-moment battle between high blood glucoses and low blood glucoses.
• It may be difficult for a sibling without diabetes, as the child with diabetes will get more attention because of the disease.  

Caring for a teenager with diabetes

Adolescence is probably the most difficult time in the life of a person with diabetes. The hormones of puberty affect behavior and also affect blood glucoses. This can be a time of rebellious behavior, which can negatively affect diabetes control. Often, this adolescent rebellion carries over to young adulthood, which is why it’s so important to lay the foundation for proper management of the disease early on.

Parents need to walk a fine line between coaching the adolescent and relinquishing control to them so they can learn to manage the disease on their own. It’s very difficult for a parent to let go at this time so that the adolescent can learn how to take care of diabetes on their own.

Sometimes it takes a few hard lessons to finally see why control of this disease is important. Adolescents have a difficult time seeing that anything bad can happen to them and don’t see the consequences for not taking care of this disease. However, taking care of diabetes today can help to ensure the continued health of the person with diabetes for 20-plus years down the road.

Helping adults manage their diabetes

Adulthood marks the time when a person with diabetes typically takes over all control of their disease management. This process takes preparation and an ability to be flexible. Unlike some chronic conditions, diabetes cannot be treated by simply taking a pill in the morning. The person with diabetes has to constantly juggle insulin and medications with diet, activity and stress. Blood glucose changes all the time and depends on minute decisions that the person makes moment to moment throughout the day. 

An adult with diabetes must be able to check his or her blood glucoses regularly. Additionally, he or she needs to also administer insulin or medication to prevent his or her blood glucoses from getting too high and eat food to prevent blood glucoses from getting too low. With proper management, this becomes second nature and less taxing.

A spouse’s care for his or her diabetic loved one

Occasionally, a spouse or caregiver may be the lifesaving difference for a person with diabetes. For many patients, their spouse or caregiver can tell when they may have life-threatening low blood glucose before they even sense it.

There are times when a diabetic person may become angry when a caregiver or spouse asks them to repeatedly check their blood glucose. A person with diabetes may also display signs of irritability and may even become combative when their blood glucose is low. It’s normal for some form of resentment to manifest on both sides when this happens. I have often counseled patients and their spouses who are dealing with these issues.

The person with diabetes needs to realize that their loved one is only asking them to check their blood glucose because they care about them. Additionally, the caregiver also needs to understand that when their loved one’s blood glucose is low and they are irritable or combative, that it’s the diabetes and not the person causing this behavior.  

Caring for an elderly person with diabetes

Besides childhood and adolescence, another time in a diabetic person’s life when they need the most help is during their later years.

Some considerations at this point:

• Elderly persons with diabetes may need help with diet or remembering to take medications.
• They may also have some complications of diabetes that limit their ability to take care of daily living activities.
• Assisted living centers and nursing homes may not be equipped or properly educated to take care of patients with insulin pumps or complex insulin plans. This is a time where the person with diabetes needs an advocate, which more than likely will be a spouse or family member.

Diabetes is a life-long journey for many. Understanding the various stages in caring for those affected by this disease is helpful for both patient and caregiver. If you have any questions regarding the care of someone who has diabetes, make sure to reach out to your health care provider for additional information to best prepare you.

Kristi Stemsrud is a physician assistant and certified diabetes educator in Endocrinology at Mayo Clinic Health System in Mankato.