Diabetic in my Home – Now What Do I Do?

Author: Mark Parkinson RPh:  President  AFC CE

Credit Hours 2.5- Approximate time required: 150 min. 

Educational Goal: 

To give a basic overview of in home diabetic care.

Educational Objectives:

1. Explain the role of the care giver in diabetes care.

2. Enumerate and explain the step in diabetes.

3. Explain what and how to monitor events in diabetes care

4. List was is involved in routine care for diabetics


1. Read the course materials.  2. Click on exam portal [Take Exam].  3. If you have not done so yet fill in Register form (username must be the name you want on your CE certificate).  4. Log in  5. Take exam.  6. Click on [Show Results] when done and follow the instructions that appear.  7. A score of 70% or better is considered passing and a Certificate of Completion will be generated for your records. 



  The information presented in this activity is not meant to serve as a guideline for patient management. All procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this article should not be used by care providers without evaluation of their patients’ Doctor. Some conditions and possible contraindications may be of concern. All applicable manufacturers’ product information should be reviewed before use. The author and publisher of this continuing education program have made all reasonable efforts to ensure that all information contained herein is accurate in accordance with the latest available scientific knowledge at the time of acceptance for publication. Nutritional products discussed are not intended for the diagnosis, treatment, cure, or prevention of any disease.


Diabetic in My Home – Now What Do I Do?


     The prevalence of diabetes in older persons is going thru the roof.  According to the Center for Disease Control, 10.9 million U.S. residents aged 65 or older have diabetes -  that’s 26 percent or 1 in every 4. Last year alone, 390,000 new cases were reported.  What that means to Adult Foster care, Developmental Disabled and Mental Health Homes is that sooner or later, you will probably have a diabetic in your home and will have to deal with it. So, let’s deal with it.

The Team Approach

     One of the first things that will impact your operations as you take care of a diabetic patient is being overwhelmed by all the things you have to know and do. There is an overwhelming amount of information on diabetes because it affects every aspect of a patient’s  health.  Diabetes is so complicated that the only good way to manage it is with a team approach.  Who’s on the team?  Doctors, nurses, podiatrists, dentists, eye doctors, dietitians, diabetic educators, social workers, pharmacists, insurance carriers - that’s who.  And now, you’re on the team.

 The Role of the In-Home Caregiver

      First. In- Home care is where the actual work is done, where the rubber meets the road, so to speak.  All those wonderful people willing to help with resources and knowledge won’t mean a thing without you, the caregiver.  There is work to do and caring to be done.  You have to see that the diabetic patient is taking care of everything that they need to do or you have to do it for them.  Bottom line, if things slide, a price will be paid later. There is no getting around it. The patient will eventually get sicker.

      Second. Somebody has to coordinate the efforts of all the team members. Usually it’s the patient who’s in charge, but now you are in charge on their behalf.

     Third. Everyone is supposed to be for the patient, but in my experience people get busy and things get in the way. It’s too bad that patients in care homes sometimes become second-rate medical concerns. It is in your business’s best interest to keep everyone on their toes.  Battle for your clients if you think any of the care team is slacking. All of the effort will be worth it because your client will live longer and require less work if they remain healthy.

The Work of Diabetes Care

     There is no “best practice” way of taking care of diabetes. There is no program that details every step to take in keeping a diabetic healthy. Every attempt to make such a program has ultimately failed because everyone is so darn unique.  It is now the prevailing medical wisdom to establish general guidelines and let the care team individualize each course of therapy and monitor for results. The care coordinator’s job is starting to sound more important, isn’t  it? 

     The Center for Disease Control and Prevention, National Institute of Health, and the National Institute of Diabetes and Digestive and Kidney Disease recommend a general four-step plan.

Step 1: Learn About Diabetes

     It’s important for you and the patient to know what is going on.  Knowing the whats, helps with the whys, which helps with the doing of diabetes care.  I recommend communicating with a diabetes educator about the subject  In brief, diabetes is a condition where the body has lost control (automatic self-regulation) of how the body produces (and sometimes stopped making) and uses insulin, which in turn affects blood glucose (blood sugar- the fuel that drives us) and blood lipids (fats like triglycerides and cholesterol ), which combined in turn affects—everything. 

     When things get out of “diabetic” whack, bad things eventually happen.  Bad things like heart attack, stroke, eye problems, nerve damage, kidney problems, gum disease, amputations, lowered immune system, and incontinency.  There is no such thing as a “slight case” of diabetes. Every case is serious and is causing now or will cause infirmity and death in the future. 

     Those who take care of the elderly might hear, “I’m old, it’s just doesn’t matter.” They just want to let things slide until they kick the bucket. But unfortunately things rarely go so smoothly.  Most commonly, letting things slide for a person of any age results in a long, drawn-out period of progressively worsening condition and suffering.  Nobody really wants a long, drawn-out period of suffering. The patient is just  overwhelmed like everyone else.  If you get one of these ‘ornery old coots who doesn’t want to change, you will have to help them change.

      Let me end this section on a more positive note. When blood glucose is kept normal, patients feel better with more energy, are less tired and thirsty, have fewer skin and bladder infections, have fewer problems with their eyes, feet and gums. Everyone wants to feel better.

Step 2 Know the Diabetes ABCs

     When the body doesn’t function automatically, you have to do things manually. In order to make the correct manual adjustments, you have to know how things are going.  That means monitoring.  The diabetic monitoring ABCs are:

     A is for A1C.  or HbA1C. Some glucose sticks to the hemoglobin molecule in the blood stream. The more glucose floating around, the more it sticks to the hemoglobin and becomes HbA1C.  Counting up the A1C shows what your blood glucose has been over the last three months. The A1C goal for many people is below 7 percent. The doctor will determine what the patient’s individual goal should be. A more day-to-day or even minute-by-minute monitoring is done by home blood glucose monitoring devices. That’s the “finger stick and put blood on a test strip” machine. They are really helpful in the day-to-day, normal living efforts of diabetics and their care givers. Finger stick readings should be recorded for future references. Up and down patterns and individual readings will help you with things like diets and determining if meds are working (or working too good) or how much to exercise.

     B is for blood pressure. The goal for most people with diabetes is below 130/80. If you have a home blood pressure machine or use one of those machines at the drug store or mall, keep in mind that blood pressure machines vary in reading all the time. At home you’re looking for long-term trends. Individual recordings are less important, unless there is a significant spike up or down. These fluctuations can be minimized if the blood pressure is taken under the same conditions every time. Keeping a long-term record of readings and sending it to the doctor will be of value. High blood pressure makes the heart work too hard, and is bad for the eyes and kidneys, too.

     C is for cholesterol. Cholesterol readings can be kind of confusing. There are several kinds blood lipids (blood fats) that all are important to keep track of. Fortunately, the doctor worries about the individual tests and readings. Your main concern is how close to the goal is the patient. For your general reference,   the LDL goal for people with diabetes is below 100. The HDL goal for men with diabetes is above 40. The HDL goal for women with diabetes is about 50. Sorry, guys, women can tolerate more fats in the blood stream than we can. LDL means Low Density Lipids and it is the bad cholesterol. Think of LDL like big fluffy cotton molecules that can easily clog up the veins and arteries. HDL means High Density Lipids or good cholesterol. These are more compact pellets that easily slip through blood vessels.

     The CDC didn’t mention it, but I would include weight in my measurements and goals. I guess the ABCWs didn’t sound too good (just joking). Seriously, though, 85 percent of type 2 diabetes patients are overweight, 54 percent are obese. That just adds to the problems later on.

Step 3 Manage your Diabetes

      This is where we roll up our sleeves and get to work. I have my own set of letters. DEHM -Diet, Exercise, Hygiene, Monitoring. Diabetes care is a marathon, not a sprint. Just keep at it. If you fall behind or stop, don’t worry, just start up again. No matter how many time you have to, keep starting up again, keep going. All your efforts do have an impact on the overall health of the patient. My number-one caregiving recommendation is to start and stick to a routine. Work at establishing patterns. They turn into habits. In-Home caregivers have the advantage of controlling the environment of the home. Bad habits are more easily broken when you take advantage of the turmoil that is caused when a person moves in and tries to adapt to the new surroundings. If routines are already in place and enforced, change will come faster. A couple of words of caution. The elderly have had a very long time to ingrain habits. Also and more importantly, they have physically lost some of the abilities to cope with change. DD and mental health homes have their own behavioral challenges to deal with. Including the patients into the education process and goal planning will go a long way. Be patient, but stick to it.


     Let me start out by saying don’t get freaked out about cooking for a diabetic. You won’t have to cook an entirely separate meal for your diabetic resident. Yes, you will have to make some adjustments, but we’re not talking about much. We’re just talking about cooking with a little bit more thought process in the menu plan. My wife is diabetic and has her blood sugar is under control. and guess what, I’ve gained weight. In reality, the average In Home caregiver, for the most part, cooks the way you’re supposed to cook any way. Plus, you’re not alone in this. Most insurances will pay for a diabetic educator and a dietician to consult with about your meal planning. I hope that takes care of some of the fear of the unknown for you cooks out there.  

     To help prepare you for your dietician consultation, let’s cover some food basics. Our body tries to convert most of what we eat into glucose. When the glucose concentration rises in the blood stream, our body starts to pump out insulin to take care of it. Some of the unused glucose is stored away as body fat. Some foods are readily converted to glucose while others have to go through a couple of steps and it takes longer. Parts of the foods we eat can’t turn into glucose or anything useable so it passes through our gut undigested as bulk fiber. We count on this bulk for proper intestinal function. 

Glycemic Index

     The glycemic index is a measure of the effects of carbohydrates in food on blood sugar levels.  Foods that are quickly converted to glucose result in a quick jump in your blood glucose concentrations. This is known as high on the glycemic index. In diabetics, their impaired insulin system is easily overwhelmed by the sugar spike, which results in all the unhealthy consequences of diabetes. For the most part, this type of food is  carbohydrates - breads, pasta, potatoes, white rice, table sugar, etc. If the food takes longer or is harder to digest, it results in a delayed or lower glucose spike. This means the food is lower on the glycemic index and the impaired insulin system is better able to handle it. I bet you have already guessed what some of these foods are. Yep, fruits, vegetables, whole grains, etc.

To Eat Fat or Not to Eat Fat,  That Is the Question.    

      We are learning more and more about fats all the time. After decades of research, we have found that a totally fat-free diet doesn’t really offer the benefits that people once thought. For some, it even caused some health problems. So fat free is out.  Is fat “in” now?  Yes and no. Let me explain.

     There are different kinds of fats. There are saturated, unsaturated, and trans fats. Saturated fats are big fluffy molecules that don’t compact easily in the blood stream. They are one of the contributors of LDL molecules (remember the cotton molecule). Unsaturated fats compact easier and result in HDL. HDL has been called the garbage truck because they can scavenge LDL and take them to the liver for disposal. Trans fat is the bad fat. We can’t use trans fats very well and they float around collecting in places. Trans fats are strongly associated with diseases. Of course, it’s a lot more complicated than this, but the take-away message is unsaturated fats- good. Saturated fats –so so, trans fats –bad. Good sources of the unsaturated fats are olive, peanut, canola, sunflower oil, nuts, fish, soybeans. Sources of saturated fats red meat, lard, butter, whole milk products like ice cream.  Trans fats are found in margarines, deep fried fast foods, processed snack goods. Yep, you’re right- good fats are in vegetables and lean meats. Bad fats are in highly processed convenience and fast foods. 

Let’s Wrap Up All This Talk About Food

     That’s enough talking about individual nutrients. After all, people don’t eat nutrients, we eat food. In general, a diabetic diet is just good old wholesome home cooked meals. Heavy on the vegetables, fruits, whole grains, moderate on the meats, whole dairy products, and controlled portions of high glycemic index foods like breads, pasta, potatoes, table sugar, and avoid fast and convenience foods. That is not much of a stretch from the menu that most of you cook right now. Your dietician or diabetic educator will explain things in more detail and help you tweak what you’re doing now. You’ll probably find that it’s a good idea to keep all of your residents are on a diabetic-inspired diet.


     Another way for caregivers to help manage their patient’s diabetes is through enabling them in exercise therapy. Exercise manages diabetes by: 1. Improving the body’s use of insulin. Continued moderate exercise can help the muscles take in glucose up to 20 times their normal rate. 2. Helps to eliminate excess body fat (a major determinant in diabetes). 3. Increases energy levels to help maintain a more active lifestyle. 4. Reduces stress and thus reduces stress hormones that influence insulin and glucose release. 5. Improves the patient’s circulation.  Exercise even lowers bad LDL lipids and increases good HDL lipids.

How to Start

     Exercise is therapy and a doctor should be consulted before starting. The CDC recommends 30 to 60 minutes of physical activity on most days of the week. But you don’t have to start out that way and you don’t have to do it all at once. It is recommended that you start low and go slow, gradually working your way up to the target exercise goal. Working your exercise program in this way is easier to start, easier to maintain, and easier to establish good habits. One suggestion on low and slow is to exercise in spurts, for example 10 minutes three times a day.


     Adult Foster Care geriatrics, Developmentally Disabled and Mental Health Homes all have their own set of challenges stemming for the unique characteristics of their client base. Use your own skills to adjust the program to meet the needs and abilities of your residents. There is no magic one-fits-all routine, and in all honesty, therapy doesn’t even have to be set exercises. Gardening, dancing, and washing a car are exercise, too.

     It is possible to exercise too much. Long bouts of intense exercise can actually increase blood glucose. Some patients are extra sensitive to exercise and it makes their blood sugars crash down to dangerous levels -hypoglycemia . Hypoglycemia usually happens gradually. Look for increasing signs of feeling shaky or anxious, light headedness, or  sweating abnormally. These are signals that the body needs more fuel and is easily managed with a high glucose tablet or snack. It is wise not to exercise during the peak effect of medications, especially short-acting insulin. Supply plenty of water during and after exercise sessions. If the patient exercises away from home, be sure to have a diabetic bracelet and emergency supplies with them. Always warm up and cool down with more intense routines.

Integrate in Normal Routines

     Some insurances pay for health club memberships, and some patients’ family have memberships. Take advantage of such resources. Outings to community pools are also a good (and cheap) activity. You certainly don’t have to turn your home into a spa. It is interesting to note that newer residential care and nursing facilities all have exercise facilities and they tout such in their advertising materials, (hint- hint). A cheap way to do this in your home is to go to Goodwill and pick up a used tread walker or stationary bike. Place the equipment by the TV and have a scheduled exercise period. Of course, walks are always a winner on many levels.

     It is  important  to make exercise a part of the scheduled routine. Routines become habits and habits are easier to maintain. Remember that you can substitute other activities to combat exercise boredom.

     Regular exercise helps manage diabetes, but there are other benefits as well. It improves muscle tone and balance ( fewer falls). It reduces stress and increases mental health, it improves self-esteem and combats depression, it strengthens the heart and bones, and it lowers blood pressure. The patient will realize these benefits even if they never lose a pound of excess fat. Bottom line, just start and keep at it. You will be doing good care for your residents.


      Taking care of oneself is much more important for the diabetic patient. The consequences of letting things slide are just too great. For example, poor foot care in diabetes can lead not just to smelly feet but infection and gangrene.  Diabetes is the leading cause of amputations. Of course, I don’t have to say it, but good personal care is the bread and butter of any successful Care Home.     


     It is common knowledge that smoking is bad. Smoking and diabetes (and a lack of exercise)  don’t mix well. Don’t smoke - enough said. You can get medication to help combat the addiction. You, the caregiver, can control the environment, which certainly goes a long way. Make it very inconvenient to smoke. Those working in mental health environments will have the roughest time because there is a strong correlation between several mental illnesses and smoking. Get help from the doctors.


     Proper hygiene is one of the essential duties for any In Home caregiver, but it is particularly important for diabetics, who present problems with circulation, hydration, nerves (especially in the extremities), and immune system. Minor cuts, skin abrasions, or gingivitis can quickly turn into major problems.  Regular, full inspections, especially of the feet, are “must-dos” in diabetes care.


     Use a soft bristle toothbrush (medium and hard can lead to cuts and abrasions). Brush at least twice a day and floss daily.  Replace the toothbrush every three months. Remove and clean dentures daily. Chronic bad breath may be a sign of mouth infections and tooth decay.


     Dry, flaky skin is a constant issue with the elderly and diabetics. Applying lotion on a regular basis helps solve this problem and provides an opportunity to inspect the skin. The act of applying lotion soothes the skin and promotes blood flow. Warm and red patches are early signs of infection. Moisture on the skin leads to early breakdown. Adult diapers must be properly and frequently changed. Sedentary patients who never change positions can experience a lack of blood flow to the skin. Portions of the skin die and open wounds (“bedsores”) result. This can be managed by shifting the patient’s body position frequently. A rolled-up towel alternately placed under one side and then the other works well. 


     Foot problems are a particular challenge for diabetics. Numbness and lack of circulation put the diabetic at greater risk for infections in an area of the body that sees a lot of wear and tear. Remember: diabetes is the leading cause of amputations. Daily foot inspections are a very good idea.

How to inspect

     Look at the top and bottom of each foot. Check between the toes and look at the toenails. A mirror might speed the process for self-inspections. Look for cuts, blisters, ingrown toenails, or any signs of infection, such as moist or wrinkly skin between the toes. Don’t be surprised if the patient can’t feel the problems that you find. Numbness in diabetes is common. 

Corns and calluses are caused by friction or pressure against the skin. They can become dry and cracked, providing an opportunity for infections to develop. They should be removed by the gentle use of a file or pumice stone. If they keep returning, think about changing shoes and watch how the patient walks.

Thick toenails might be caused by a toenail fungus and they become a site of future athlete’s-foot infections.  If you intend to tackle the thick toenail fungal infection yourself, plan on at least 12 months of treatment. Toenail infections are particularly hard to get rid of.  Of course you’re not alone on the care team.  Podiatrists have the knowhow and proper tools.   

Tingling and sensitive feet are a problem for diabetics. You can get soft, seamless diabetic socks and special shoes. Some insurance plans will pay for them. Keeping the feet elevated can also help. There are numbing creams and mild capsaicin lotions that might also help and you could have a discussion with the doctor or podiatrist about them.


Signs and Symptoms

     Diabetes has been called a silent disease because the initial signs are not seen or felt. You as a caregiver must learn to see the early warning signs. Being cranky, bad tempered, or confused might be the result of hyperglycemia or hypoglycemia. Other signs of hyperglycemia (too much blood sugar) are frequent urination, extreme thirst, blurred vision, or unusual fatigue. Signs of hypoglycemia (low blood sugar) are frequent yawning or lacking energy, an inability to speak or think clearly, loss of muscle coordination, sweating, twitching, seizure, fainting, feeling like you’re going to pass out, or becoming quite pale. Have the doctor include in your care plan what to do in both cases . Make sure all substitute caregivers are trained in the details.     

Blood Glucose Monitoring

     Diabetics have been called “lucky” as far as chronic diseases go, because the patient can use a home glucometer to get a near-instantaneous blood-sugar reading to see how well they are doing. Finger sticks can take a lot of the guess work out of caregiving. If there are any unusual signs, symptoms, or changes in your patient’s condition, you can take a finger stick and see whether the blood sugar is too high or low.

     Readings can also help you tweak a menu for optimal results. For example, my wife found out that dishes with rice and ham sharply elevate her blood sugar, so she eats smaller portions of that combination and fills up on vegetables.

     Home monitoring of blood-sugar levels can also help you manage optimal exercise times, determine medication effectiveness , and decide a new medication is doing what it is supposed to do.

     Monitoring also gives you a common point of reference when communicating with other members of the care team and the patient’s family.  For example, the ideal communication might be, “Mr. Smith is not doing very well today. After a period of confusion, I checked his BG and found it was 60. I gave him a glucose tablet as per instructions in the care plan. This has happened several times this week. Doctor, I think you should review his medications.” Compare that to “Doctor, my patient is feeling cranky and acting strangely, What can you do about it?”. See how powerful BG monitoring results are and how professional they make you appear. 

Blood Sugar Monitors (Glucometers)

     Most often, your resident will already own their own glucometer. If so, find the owner’s manual and read it. Unlike other manuals, these are written so that anyone can use them. I recommend finding the toll-free help desk telephone numbers. The help desk operators are really quite helpful. If you don’t have an owner’s manual, go to the company’s website, find the help desk number, and ask for a new manual.  Or just get a new machine (more about that later).

     Next, inspect the machine. Does it work? Is it clean? Do you have all the parts? Use the manual as a point of reference for answering these questions. If it doesn’t work or starts to act strangely, check the battery (usually a watch/hearing aid-style battery. You can usually find replacements in the electronic sections of department stores. Etched on the battery are identifying marks that tell which type to buy.

If error messages appear, refer to the owner’s manual. Clean the meter with soap and water using a wash cloth. Alcohol pads are ok, but it can be tedious to use those to clean. Wear gloves (after all, you’re dealing with blood). Look for the lancet device and lancets (the needle-like tools you place in the device that usually looks like a pen). Unused lancets have a twist-off top. You can buy the lancet device and lancets separately if they are missing. When making such a purchase, be sure the device and lancets match.

Every machine will be different but the basic instructions are:

  1. Place a lancet in the lancet device. Hold the device next to the skin. Avoid sensitive spots like finger tips to make the test less painful. The sides of the fingers have fewer nerve endings. Click the lancet trigger. If you don’t get blood you can: adjust the lancet depth gauge (to puncture a little more deeply), swing the hands around to push blood to the fingertips, “milk” the fingertip by squeezing it after puncture, or try another spot. A point of caution when choosing alternative sites: Different points of the body can give different readings. Blood from the arm might be different than blood from the fingers. Consult with your doctor or diabetes educator.
  2. Place a drop of blood on the strip. For most machines, the strip should first be placed in the machine. Review the owner’s manual.
  3. The reading should only take seconds to appear. Record the data. If the reading is off, repeat to verify.


New Machines

     There are more than 25 glucometers on the market. When it comes right down to it, the brand really doesn’t matter as long as you learn how to use it and are comfortable with it. 

     The cost of the machine is almost irrelevant. Insurance plans typically pay for the machine or you can get one free from the manufacturer. If you do have to shell out some cash, pay particular attention to the cost of the test strips. Insurance plans also typically pay for the strips.

     Determine which brand the insurance company prefers and you’ll save yourself a lot of hassle. On the back of the insurance card, you’ll find a toll free number that you can call and ask about brand preferences.

      If you want the insurance plan to pay for testing supplies, you need a prescription. To save you some troubles, have the doctor write generically. For example, it’s better to write “Diabetic testing machine and supplies, refills for a year.” When the doctor writes the Rx like this, the pharmacy has greater latitude and they can make brand adjustments as needed if any difficulties arise or the patient switches insurance carriers.

Newer glucometers have many features. Don’t get caught in the “Shiny New Object” syndrome. If you’re never going to use all the doodads, why buy a machine that has them. Overall though, just relax. You’re going to have plenty of time to learn to use and become comfortable with this technology. The diabetic educator will be useful in helping you learn about the whole testing process. The rest of the care team can help, too.

Final Note on BG Testing

      The doctor will help you decide when and how often to test. Be sure to cover the subject with him or her and get it in the care plan. There will be times when you need to test outside the regular schedule. I recommend getting an extra box of “just in case” strips so you don’t have to dip into the regular supplies. Insurance companies can be an awful pain when it comes to early refills. 


Other Monitoring

 BP and Weight   

     Other signs to monitor at home include blood pressure and weight. Many aspects of diabetes affect the blood system. Monitoring the BP can help you manage diabetes and the patient’s overall health. Monitoring weight is useful for assessing the long-term effects of care. Be sure to record all your readings in the care plan.


     Don’t forget to monitor the effects of the medications. Are they working?  Your finger stick readings will help determine if they are. The timing of medicines is an important factor as well, especially with short-acting insulin. Learn about the whens of dosing. The timing will affect when to exercise, when to eat, and when to travel outside the home. Medication timing can even affect the therapy itself. For example, sometimes just changing the administration time can solve therapy problems . Keep in touch with the doctor about any such concerns.

     Are there side effects? The paperwork from the pharmacy will tell you what to look for. Communicate any observations to the doctor. Don’t be surprised if the doctor says they’re not going to do anything because the side effect doesn’t outweigh the benefit of the drug. Of course, you have a different perspective:  You live with the patient and the doctor doesn’t. Don’t be afraid to battle for your client, but be professional about it.


     And the final factor to monitor is the home environment. Watch for things that can nick or cut “at-risk” feet. Stress affects diabetes. Be aware of the overall stress of the home or the stress level when visitors arrive. It is wonderful for loving friends and family to visit, but they can also attempt to slip the patient a few extra unplanned treats and snacks. In diabetes, loving someone to death takes on a whole new meaning.  

Step 4 Get Routine Care

     As part of the overall care strategy, you must track routine scheduled visits to other health providers. A diabetic should see their prescriber at least twice a year. the A1c level should be tested at least twice a year as well. Annually, the patient should receive a lipid panel, a foot exam, a dental checkup, and an eye exam (although not all at once, of course). Immunizations should also be performed according to recommendations, such as annual flu shots every year, and pneumonia vaccinations every five years.  That is a lot to keep track of. The most logical place to manage all these visits, records, events, and schedules is in the diabetes care plan in the patient’s folder. It is an excellent place to keep all the necessary records and schedules. You can pull it out whenever the patient goes to the doctor, or when other healthcare professional visit your home.


     As a member of the diabetes healthcare team, the caregiver must learn the special needs of the patient and how to take care of them.  The four-step plan from the Centers for Disease Control is an excellent starting point.  Working with other team members, the caregiver can establish an individualized care plan that will help the patient remain healthy for a long time.  I hope this CE has started you path of good caregiving.

Mark Parkinson RPh.



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Diabetic in my Home – Now What Do I Do?

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