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End-Stage Diabetes: What to Expect

Diabetes is a common illness you can control effectively using diet and medication and continue to live for decades. However, controlling end-stage diabetes can be an uphill task. Also, the older the patient gets, the harder it is to manage the effects of end-stage diabetes, especially if there’s another illness in the mix. Some of the symptoms of this condition are cardiopulmonary disease, cancer, Alzheimer’s disease or other dementia. Together, these symptoms can cause an end-stage diabetic patient to need additional support as the diseases complete their natural progression.

End-Stage Diabetes

Do diabetic patients qualify for hospice care?

If the illness troubling you is diabetes alone, you won’t need hospice care. But if another severe illness is in the mix, the illnesses can shorten a patient’s life expectancy to below six months if the illnesses follow their usual pattern.

Will I keep my insulin while in hospice care?

If the body is neither making nor using insulin correctly, a doctor may prescribe insulin shots to control a patient’s blood sugar. When it’s untreated, increased blood sugar levels can lead to long-term complications.

Nevertheless, when the patient reaches the end-of-life stage, diabetes management should focus on immediate symptoms control … of low and high blood sugar rather than trying to avert long-term complications. For instance, if the patient consumes less food while still taking their normal insulin dose, they go through the impact of low blood sugar such as sweating, blurry vision, heart palpitations, irritability, hunger, anxiety or trembling.

Generally, Type 1 diabetics will need to take their insulin, though it may be curtailed depending on the amount of food they eat.

Patients living with Type 2 diabetes in hospice care will have to make sure their medication is reviewed. They may have to discontinue taking insulin because high blood sugar at the end-of-life stage will not result in additional complications. If they continue taking insulin, that may cause low blood sugar and hence, additional discomfort.

A doctor will review every diabetic patient’s medication list to prescribe precisely the perfect combination of medication that works for their current condition. All other medicines that only benefit in the long-term, maybe discontinued, provided the patient’s life expectancy is short-term. Also, it may be necessary to introduce additional medications that offer immediate benefits in terms of comfort and the patient’s quality of life.

End-stage diabetes hospice: Taking care of end-stage diabetics

Caregivers have to stay alert 24/7 for signs/symptoms of high and low blood sugar signs/symptoms to ensure the patient’s comfort.

Signs/Symptoms of high blood sugar include:

·       Increased urination

·       Thirst          

·       Increased fatigue

·       Infections such as thrush

Signs/ symptoms of low blood sugar include:

·       Anxiety

·       Paleness

·       Irritability

·       Heart palpitations or an increased pulse

·       Trembling

·       Hunger

·       Blurry vision

·       Sweating

Caregivers should watch out for these symptoms. Once identified, they should alert the patient’s hospice care team to manage them before it’s late.

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