There are other factors to consider when caring for elderly people with diabetes in the care home setting. These factors are set out below.
Weight management
Weight is a significant factor in the development and management of Type 2 diabetes. For residents who are overweight or obese, a reduction in weight of between 5 and 10 per cent may be beneficial. Specific goals should be identified and negotiated as part of the care planning process.
Suggestions on reducing the fat and sugar content of recipes for people with diabetes who are overweight are available under the managing your weight and also recipes section.
Catering for people with diabetes who are overweight does not require you to use special recipes, but Diabetes UK produce a range of recipe books that may help care home catering staff in menu planning. Remember that reducing the fat and sugar content of recipes for most of your residents is not appropriate – check with the resident’s registered dietitian for specific advice.
Underweight and malnutrition
A registered dietitian can advise more fully on specific individual requirements. It is important to note that for this specific resident a therapeutic high energy-high protein diet may still be appropriate. Nutritional therapy may also include the use of nutritional support, for example, via supplement drinks or nasogastric feeds. Where high blood glucose levels are noted in a person receiving nutritional support, it may be necessary to adjust diabetes medication to achieve blood glucose levels as near as possible to normal levels. Discuss with the resident’s healthcare team for more guidance.
Hypoglycaemia
More information on the signs, symptoms, treatments and causes of hypoglycaemia (or hypos) can be found in the section hypoglycaemia. It is important to establish whether this is relevant to each resident on an individual basis since there are nutritional considerations, such as:
- quantity and timings of carbohydrate containing foods and drinks
- the potential need for snacks
- timings of meals in relation to medication timing
- effects of alcohol
Oral health
It is estimated that people with diabetes can be up to approximately three times more likely to develop gum disease than people without diabetes. Their nutritional status may be compromised as a result of poor food and drink intake. Residents with diabetes and gum disease should be identified and dietary adjustment made according to specific need.
Dehydration
It is widely accepted that the older person is at a greater risk of dehydration for a number of reasons. A resident with diabetes and uncontrolled diabetes may be at additional greater risk of becoming dehydrated as a result of polyuria. Particular attention should be made to the monitoring and provision of fluid for this resident, and treatment modified accordingly so as to limit symptoms of hyperglycaemia.
Reviewed March 2010
Next review September 2011