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THE DIABETES CAREGIVER: Basics

Five changes in your loved one that should raise concern in you

BY:MARGARET FARLEY STEELE

Jean Kostak, MS, RD, CD-N, center administrator, Joslin Diabetes Center affiliate, New Britain General Hospital, New Britain, CT, advises caregivers to watch for the following:

1. Symptoms: shakiness, sweating, weakness, dizziness, irritability, hunger, headache. Later symptoms: mood swing, staggering gait, weepiness or anger

 

Indicates: Low blood sugar (hypoglycemia)

 

What to do:

-Check blood sugar to confirm; take 15 grams of fast-acting carbohydrate immediately (4 ounces juice or regular soda; 3 to 4 teaspoons sugar in water; 4 to 5 glucose tablets)
-Test blood sugar again in 10 to 15 minutes; repeat ingestion of 15 grams of carbohydrate if glucose level is still below 70 mg/dl. Eat a meal within the hour. If symptoms persist, call the doctor
-If extreme confusion or unconsciousness occurs, give glucagons, if available, and call the doctor

 

2. Symptoms: Thirst, fatigue, frequent urination, drowsiness, blurred vision

 

Indicates: High blood sugar (over 240-300 mg/dl) 

 

What to do:

-Check blood sugar
-Continue normal eating
-Check urine for ketones if blood sugar is over 240-300 mg/dl
-Drink water often
-Notify doctor or diabetes educator
 

3. Symptoms: High blood sugar and abdominal pain, nausea, vomiting, extreme drowsiness, rapid breathing, flushed skin, sweet fruity odor to breath

 

Indicates: Diabetic ketoacidosis, caused by lack of insulin

 

What to do:

-Test for urine ketones
-Call doctor immediately or go to emergency room
 

4. Symptoms: Pain and numbness, tingling sensation in the extremities

 

Indicates: Peripheral neuropathy (nerve damage that affects feeling in the hands and feet)

 

What to do: 

-Discuss with physician
-Protect the feet from injury
-Discuss foot care with diabetes educator and/or podiatrist

 

5. Symptoms: Blurred Vision

 

Indicates: Diabetic macular edema (accumulation of fluid in the central part of the retina of the eye)

 

What to Do:

-Contact physician
-Be sure to schedule a dilated eye exam every year

 

For more on The Basics, click on:
The Basics: How to Check Blood Glucose
The Basics: Separating Facts from Fiction