Understanding Diabetes as a Caregiver
Learn what diabetes is, how food, activity and medicine affect blood sugar, what a care worker does and what warning signs to watch for.
Table of contents
Diabetes affects how the body uses sugar for energy. More than one in ten people in the United States has it, and it is much more common in older adults, so most care workers will support someone with diabetes. You do not manage the disease. You help with meals, activity and reminders, and you notice when blood sugar might be too low or too high.
What You Will Be Able to Do
- Explain what diabetes is in plain words.
- Describe what makes blood sugar go up and down.
- Use the plate method to build a meal.
- Say what a care worker does and does not do.
- Name the warning signs that need action right away.
What the Work Looks Like
Your day with a client who has diabetes usually means making meals that match the care plan, reminding them about medicines if that is part of your role, encouraging movement, checking their feet and writing down what you saw. Some aides also check blood sugar with a meter if the state and the care plan allow it. Most aides do not give insulin.
Diabetes in Plain Words
Food breaks down into glucose, a sugar the body uses for fuel. Insulin, a hormone from the pancreas, moves glucose out of the blood and into cells. In diabetes, there is too little insulin, the body does not use it well, or both. Glucose then builds up in the blood.
- Type 1: The body makes little or no insulin. The person needs insulin every day.
- Type 2: The body does not use insulin well. It is treated with food choices, activity, pills, injections or a mix. This is the most common type.
Over time, high blood sugar damages blood vessels and nerves. It can harm the eyes, kidneys, heart and feet, and it slows healing.
What Moves Blood Sugar
| Raises blood sugar | Lowers blood sugar |
|---|---|
| Carbohydrates: bread, rice, potatoes, fruit, sweets | Insulin and some diabetes pills |
| Illness and infection | Physical activity |
| Stress | Skipped or late meals |
| Missed diabetes medicine | Alcohol |
Meals and the Plate Method
Carbohydrates raise blood sugar the most, so people with diabetes watch how much they eat and when. The care plan or dietitian sets the diet. A simple plan that fits many people is the plate method, using a 9-inch plate:
| Part of the plate | What goes there |
|---|---|
| Half | Non-starchy vegetables, such as salad, broccoli, green beans |
| One quarter | Lean protein, such as chicken, fish, eggs, tofu |
| One quarter | Carbohydrate foods, such as rice, pasta, potatoes, bread |
Choose water or unsweetened drinks. Serve meals on time, because a late meal can cause a low for someone on insulin. Report a client who skips meals or eats much less than usual.
What Will Hurt a Client on Day One
Low blood sugar can come on in minutes. Look for shakiness, sweating, a fast heartbeat, hunger, confusion or a sudden change in mood. A person who is awake and can swallow needs fast sugar, such as 4 ounces of juice. Then call the nurse.
High blood sugar usually builds more slowly. Look for strong thirst, frequent urination, tiredness and blurred vision. Report these to the nurse.
Warning: Call 911 if the person is unconscious, cannot swallow safely, has a seizure, or has very deep, fast breathing with vomiting or a fruity smell on the breath. Never put food or drink in the mouth of someone who cannot swallow safely.
Feet are the other big risk. Diabetes can take away feeling, so a small blister can become a serious wound. Look at feet when you help with bathing, and report anything new. A person with diabetes should not walk barefoot.
Your Role and Its Limits
| Usually part of the job | Usually not part of the job |
|---|---|
| Preparing meals from the care plan | Changing the diet |
| Reminding about medicines | Giving insulin, unless your role and state allow it |
| Encouraging activity | Changing doses or skipping them |
| Checking feet and skin | Cutting corns, calluses or thick nails |
| Reporting and documenting | Explaining what a number means to the client |
The rules differ by state and agency, so check your care plan, and ask the nurse if you are unsure.
Tools You Will See
- A glucose meter, test strips and lancets, or a continuous glucose monitor worn on the arm or belly.
- Insulin pens or vials, and sometimes an insulin pump.
- Glucose tablets or juice for lows.
- A sharps container for used needles and lancets.
Your First Exercise
Look at your next meal and try to sort it into the plate method. Which foods are carbohydrates? How close is the plate to half vegetables? Then read the nutrition label on a food in your kitchen, and find the total carbohydrate per serving. About 15 grams counts as one carbohydrate serving for many meal plans.
Check Your Understanding
1. Your client on insulin normally eats lunch at noon, but today she says she'll wait until 3. Why does that matter?
A late meal can cause low blood sugar in someone taking insulin. Encourage her to eat on schedule, and tell the nurse if she refuses.
2. A client suddenly gets sweaty, shaky and confused. What should you suspect?
Low blood sugar. If he can swallow, offer fast sugar and call the nurse. If he cannot swallow safely, call 911.
3. A client asks you to fix his plate. Which fills half the plate?
Non-starchy vegetables.
Key Takeaways
- Diabetes means the body has trouble using glucose for energy.
- Food, activity, medicine, illness and stress all affect blood sugar.
- Half the plate should be non-starchy vegetables.
- Lows can happen fast, and they need fast sugar if the person can swallow.
- Report anything new on the feet.
- Call the nurse with concerns, and call 911 for emergencies.