Special Considerations
Diabetes can lead to a variety of short - and long-term complications affecting virtually every system in the body. As a caregiver, it's important that you understand how to recognize and manage these situations
Low Blood Sugar (Hypoglycemia)
If a person with diabetes hasn't had enough to eat, has taken too much insulin, exercised vigorously, or has an infection - or sometimes for no apparent reason - their blood sugar can fall too low. This is what people used to call an "insulin reaction." Today, it's more likely to be called "hypoglycemia" or "a low." Everyone is different, so your doctor will give you guidelines on what blood sugar level constitutes a low for the person you're caring for.
Low blood sugar isn't pleasant. You may notice the person sweating, getting cranky, or even walking strangely. Understand that their irritability isn't directed at you. The person experiencing a low may feel shaky, hungry, nervous, confused, or have a headache, or as they get older, they may not feel the symptoms coming on at all. That's why frequent blood sugar monitoring is crucial.
If blood sugar is low or falling, many doctors recommend the 15-15 rule - eating 15 grams of carbohydrate every 15 minutes until blood sugar levels return to normal. This can be fruit juice, hard candy, or special glucose tablets you keep on hand. Avoid overcompensating for the low. Wait 15 minutes to allow the sugar to work, then re-test. This process, always waiting 15 minutes between eating and re-testing, can be repeated until blood sugar levels return to normal.
In a severe case of hypoglycemia, call 911. If blood sugar drops too low, a person can lose consciousness. Talk to the doctor about how to administer a glucagon injection, which provides a hormone that stimulates the liver to release stored blood sugar quickly.
Sick Days
Sure, anyone can catch a cold or the flu. But for people with diabetes, a bug can make it very hard to keep blood sugar under control. Why? Stress hormones released when you're ill can raise blood sugar. Plus, it can be harder to stick to a meal plan. And vomiting and dehydration further complicate the situation.
Make sure you have a specific sick day plan worked out with the doctor in advance. If the person you're caring for has type 1 diabetes, you never want to stop insulin injections, even if they're not eating. You'll need to know how to keep their blood sugar in control. Frequent testing will help them monitor blood sugar levels. If they are too sick to eat or can't keep solid foods down, they can get the necessary carbohydrates from ginger ale, non-diet soda, juice, ice pops, or gelatin. If they can't eat at all, just sipping small amounts of these foods hourly will help.
Sexual Issues
If you're in a relationship with a person with diabetes, it's important to understand that high blood sugar can have some sexual side effects. For women, this can mean reduced sex drive and lubrication. For men, damage to the small blood vessels of the penis can result in erectile dysfunction - the inability to maintain an erection during intercourse. Fortunately, there are answers to all these issues. Understanding that these potential problems exist and working as a team with the doctor will help you find a solution.