Diabetes Management in Home Health Care

December 18, 2017

According to the latest statistics from the Centers for Disease Control and Prevention (CDC), 30.3 million people in the United States have diabetes. The percentage of adults with diabetes increases with age, reaching a high of 25.2% in 2015 among those aged 65 years or older. Diabetes remains the seventh leading cause of death in the United States in 2015, with 79,535 death certificates listing it as the underlying cause of death, and a total of 252,806 death certificates listing diabetes as an underlying or contributing cause of death.

Diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIH), is defined as a disease that occurs when blood glucose, also called blood sugar, is too high. Blood glucose is the main source of energy and comes from the food we eat. Insulin, a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy. Sometimes the body doesn’t make enough—or any—insulin or doesn’t use insulin well. Glucose then stays in the blood and doesn’t reach the cells.

Most middle-aged and older adults (90-95% of cases) with the disease have Type 2 diabetes where the body does not make or use insulin well. If not managed properly, over time high blood glucose leads to problems such as heart disease, stroke, kidney disease, eye problems, dental disease, nerve damage and foot problems.

As home health care professionals care for an aging population, they are increasingly becoming an essential part of the daily management of patients’ diabetes. When caring for a diabetic patient, it’s important the home health care provider ensure that both the patient and his or her family understand the goals of any diabetes management program. This involves educating the patient and family about the medication treatment plan – the timing; need for self-blood glucose monitoring; preparing/administering injectable and/or oral medication; knowing the signs/symptoms of and treatment for hypoglycemia/ hyperglycemia; when to contact the home health agency; and how to identify signs and symptoms that require emergency medical attention.

In addition, home health care providers work with patients and their families to further understand how a variety of aspects of diet, exercise and medication could potentially affect blood sugar levels and what to do in response. Administering insulin properly through the use of an insulin pen helps patients have better control over their diabetes between home health care visits. Through demonstrations with a home health care professional, patients understand proper usage to reduce medication errors and better blood sugar control. Further, blood sugar levels are prone to fluctuation with exercise. Home health care professionals can work with patients to establish a plan on testing blood sugar levels before, during, and after exercise and how to ensure they are exercising within safe limits.

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