The number of people with both type 2 diabetes and dementia is rising. It is important to know that diabetes being a direct causal factor of dementia remains unproven. The diagnosis of type 2 diabetes is rising because of changing lifestyles and contributory factors including a diet rich in sugar and fats, poor exercise regimes and obesity. However, with early diagnosis and treatment, people are living with diabetes into old age.
Diabetes and dementia may manifest simultaneously: one is potentially life threatening, the other causes severe, progressive loss of memory and cognitive function. Where they coexist, carers of those living with dementia are faced with challenges in everyday living as well as challenges in blood glucose monitoring and medication administration. The coexistence of the two can have enormous consequences – complications from one condition having a significant effect on the course of the other.
Tips for caring for loved ones living with both diabetes and dementia
- Ensure blood glucose monitoring is done as often as possible or when needed to ensure blood sugar levels stay normal. Initiating testing can sometimes be challenging and should therefore be carried out when your loved one is as calm as possible.
- Depending on the severity of dementia with your loved one, you should try and foster independence in maintaining stable blood glucose levels, for example with insulin. However it is always best to monitor insulin doses because an insulin-dependent diabetic living with dementia may really struggle to calculate their insulin dosage or self-administer, which can be highly dangerous.
- High blood glucose levels can make your loved ones pass more urine than usual. They may therefore experience frequent visits to the toilet if their diabetes is not controlled. This can result in incontinence if they forget where the toilet is. Make sure your loved ones are placed in an en-suite bedroom or near toilet facilities. This will also reduce episodes of incontinence and resulting distress and minimise risk of falls.
- The use of neuroleptic medication must be carefully considered as it may greatly exacerbate the drowsiness that people with type 2 diabetes often experience. Medications can also be very difficult to swallow and we advise requesting these medications in a syrup or powder form if it is available.
- A diabetic living with dementia may have difficulty remembering what their food intake has been, and may end up eating too much (leading to high blood sugar) or too little (leading to hypoglycaemia, which is particularly dangerous). Carers may need to monitor food consumption if this is not being done so already. Hypoglycaemia can lead to life threatening situations for persons with dementia especially if they are still driving or functioning independently in society.
- Persons with dementia struggle to communicate and may not be able to inform their care providers if they are feeling unwell due to unstable glucose levels, care providers need to ensure to have sweets and snacks close by in case of an episode of hypoglycemia. It is also important for the person with dementia and diabetes to eat regular small healthy meals and snacks.
- Persons with diabetic foot ulcers scored lower on cognitive tests when compared to individuals with diabetes without this complication. The same phenomena is found when persons with dementia have an infection. Therefore it is vital to keep your client with dementia and diabetes healthy and infection free.
We hope these basic tips can help you better care for your loved ones living with dementia and diabetes. If you have something to share with us, visit our Facebook Page and let us know. We always look forward to your feedback.