Guest Post David Mapletoft, Diabetes Educator
Living alone is increasingly on the public radar. One in four Australian households is a lone-person household, and rates have increased sharply since the 1970s.
Throughout the Western world lone-person households have become increasingly common, and this trend is spreading to non-Western countries. In some quarters these developments have been interpreted as signifying a decline of commitment to family living, increasing social fragmentation and a rise in loneliness.
For others, the growth in living alone has been celebrated as reflecting the greater choice that people have in their living arrangements and lifestyle. Living alone is a little more common among women than among men- 55% of those living alone are women.
Safety First – It Could Save Your Life
The first thing to consider is to be safe: especially if you are prone to low blood glucose levels i.e using insulin or other glucose lowering medication.
Knowing how to identity the early symptoms and causes of a low blood glucose level, and then how to treat is a priority if you love alone. Ideally you will have spoken about this with your diabetes educator and doctor, and have a plan in place to reduce your risk of hypoglycaemia
For some people living with diabetes becoming unconscious with a hypoglycaemia episode is a real risk: potentially a life threatening risk.
Identifying and treating the EARLY symptoms will help to lower your risk of a severely low blood glucose level.
The early symptoms are:
- Nervousness or anxiety
- Sweating, chills and clamminess
- Irritability or impatience
- Rapid/fast heartbeat
- Lightheadedness or dizziness
- Hunger and nausea
- Blurred/impaired vision
- Tingling or numbness in the lips or tongue
- Weakness or fatigue
Later symptoms include:
- Confusion, including delirium
- Anger, stubbornness, or sadness
- Lack of coordination
- Nightmares or crying out during sleep
Talk to Your Team
- If you frequently experience hypoglycemia, talk to your diabetes educator or doctor.
- Let them know that you live alone and that preventing hypoglycemia is a priority for you.
- If you don’t use one already, your diabetes educator or doctor may suggest switching to a rapid-acting oral medicine or insulin. The newer, rapid-acting pills and insulins carry less risk of hypoglycemia than the older, slower-acting ones. Also, the new peakless basal insulin analog, insulin glargine (brand name Lantus), may have less risk of hypoglycemia than older, long-acting insulins.
- Using an insulin pump can also reduce the risk of hypoglycemia as long as basal and bolus doses are calculated correctly.
- You might also ask your doctor if using a continuous glucose monitoring system would be helpful for you. Such devices can reveal patterns in blood glucose levels that are often missed by regular monitoring.
Treatment Goal Review
If you live alone your blood glucose level targets may be a little different to other people living with diabetes. This may depend on the type of medication that you use, and on the frequency and risk of low blood glucose level occurring.
It may be that you will be advised to attempt blood glucose levels no lower than 5mmols; or treat a blood glucose level of 5 mmols rather than wait until it gets below 4 mmols.
Depending on your comfort level, it can be to your advantage to let people near you know that you have diabetes, such as neighbors, friends, or local shopkeepers with whom you have regular contact. You may want to ask a few neighbors if you could call them in the event of a “diabetes emergency.” If they say yes, keep their phone numbers in an accessible place, or program your phone to call them with the press of a button.
Consider some form of daily “I’m ok” communication with friends or family. e.g 1. a daily Facebook or Tweet post or 2. a daily phone call or SMS that somebody you know is delegated to follow each day. Have them most back that they have read it. Have a plan for them to follow if a) they don’t see a post b) no response is replied back to you. You can give a person you trust an extra key to your house so that someone can gain entry if you are unable to open the door.
Sick Days Type 1
Sick Days – Type 2
Being sick is a physical stress on the body that usually causes blood glucose levels to rise, even if you are not eating. This means it’s important to continue taking any insulin or medicine that you usually take (and possibly more, if directed to by your doctor). It is also important to continue monitoring your blood glucose level so you can respond to out-of-range levels and catch any problems before they become major. If your blood glucose levels do seem out of control and you are not sure how to treat the problem, call your health-care provider.
Be prepared: have a sick day management plan ready to roll – even before you are sick. Share this with your trusted friend or family member so that they can support you here and even arrange medical assistance for you as per plan.
Diabetes management ideally will be adapted to individual needs. Living alone and aging has special needs, and with diabetes comes the extra burden of managing safely with medications and low blood glucose level prevention and management.
Treatment goals and management skills may need to be assessed more frequently if you live alone.
For people living with diabetes who are over 60 your diabetes educator, dietitian, doctor need to monitor more closely functional and cognitive changes. Changes that may occur relatively quickly.
If you have a family member who is in this age group, contacting your local community health services may provide some assessment options for them to stay safe in their own homes.