While there is no proven direct link between diabetes being a direct causal factor of dementia, the number of type 2 diabetes and dementia is rising.
Diagnosis of type 2 diabetes is increasing due to multiple reasons. Sugary and fatty diets, little exercise and obesity all play a role in the prognosis. Early diagnosis and treatment are important factors in living with diabetes well 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 in a patient, carers of those living with dementia are faced with the challenge of blood glucose monitoring and medication administration. This places the carer under increased pressure in everyday work.
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
Blood glucose monitoring needs to be done as often as possible to ensure blood sugar levels remain normal. Make sure your loved one is in a calm mood as testing their levels can be a challenging process.
Depending on your loved one’s severity of dementia, you can create a sense of independence in maintaining stable blood glucose levels with insulin. You will need to be involved in monitoring insulin doses though, as an insulin-dependent diabetic living with dementia may struggle to calculate their insulin dosage or self-administer, which can be highly dangerous.
With high glucose levels comes the need to urinate more often. If their diabetes is not in check, your loved one may need to frequent the bathroom. 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 in distress and minimise the risk of falls.
Neuroleptic medication must be carefully thought out, as it can exacerbate drowsiness that people with type 2 diabetes experience. If your loved one needs to be on this, ask your pharmacist if the medication has a powder or syrup form as swallowing pills can become a difficult task.
High blood pressure can be brought on as dementia patients may forget they have eaten, resulting in them overeating. If a patient forgets to eat entirely or under eats, it may cause hypoglycemia, which is particularly dangerous. Carers may need to monitor food consumption if this is not being done so already. Hypoglycemia can lead to life-threatening situations for persons with dementia especially if they are still driving or functioning independently in society.
Dementia patients may struggle to communicate and are unable to inform their carers that they are feeling unwell due to unstable glucose levels. Carers should have sweets or snacks nearby in case of a hypoglycaemic episode. It is also important for the person with dementia and diabetes to eat regular small healthy meals and snacks.
Keeping your patient with dementia and diabetes healthy and infection-free is important. People with diabetic foot ulcers scored lower on cognitive tests in comparison to those with diabetes who do not have this complication. The same was also discovered in those who have dementia and an infection. Overall health and well-being directly impact brain health and abilities of patients with dementia.