Diabetes and Dementia

A diagnosis of either dementia or diabetes is devastating—but both? To effectively care for a client or loved one with dementia and diabetes, it’s important to grasp what each condition entails, preventative and management strategies, and ways to handle living with the dual diagnosis. 

WHAT IS DIABETES? 

Diabetes is the seventh leading cause of death in the U.S. according to the CDC. More than 34 million people have it—and many don’t even know it. There are several categories of diabetes: 

• Type 2 diabetes: Type 2 is the biggest diabetes threat, accounting for 90-95% of diabetes diagnoses. This lifelong condition is what most people think of as diabetes. It’s caused when cells are insulin resistant, meaning they don’t respond normally to insulin. The pancreas keeps cranking out more insulin to trigger a response and blood sugar rises, creating a host of health problems. 

• Type 1 diabetes: This condition occurs when the immune system mistakes healthy cells for foreign invaders and tries to destroy the insulin-producing cells in the pancreas. The result is the body’s inability to produce insulin. Type 1 affects only 5-10% of people with diabetes. 

• Prediabetes: People with this condition have higher-than-normal blood sugar levels but haven’t quite reached Type 2 diabetes level. But the potential to develop Type 2 diabetes is there—in fact, the CDC warns that people with prediabetes who take no action will often develop Type 2 diabetes with five years. 

WHAT IS DEMENTIA? 

Dementia is a progressive condition that affects 50 million people around the world. Dementia is an umbrella term for multiple conditions (Alzheimer’s, Vascular dementia, Parkinson’s disease dementia, etc.) and their resulting behaviors. The Mayo Clinic defines dementia as “a group of symptoms affecting memory, thinking and social abilities severely enough to interfere with your daily life…. Dementia is caused by damage to or loss of nerve cells and their connections in the brain.”

WHAT’S THE CONNECTION?  

While diabetes and dementia may seem unrelated, research suggests that people with diabetes (particularly Type 2) are at a higher risk for developing dementia—perhaps twice as likely, in fact.

Why? There are several reasons. First of all, diabetes can cause damage to blood vessels, reducing blood flow. Vascular dementia, which occurs when the brain is damaged (often by reduced blood flow to the brain), is a logical potential result. Other research supports the association between blood sugar and dementia: Since the brain relies on glucose for energy, neuronal damage can result when blood sugar drops. And too much sugar in the blood can cause inflammation throughout the body, a condition that people with Alzheimer’s also share. 

WHAT CAN YOU DO?  

The best way to lower the potential risk for dementia and cognitive decline from diabetes (not to mention kidney damage, cardiovascular disease, nerve damage, skin conditions, and other negative results of the condition) is to avoid diabetes altogether. If a loved one already has it, managing it effectively is the next best strategy. Eating well, exercising often, keeping weight under control—it all makes a difference, even if improvements come in small increments. Prescription drugs can also help keep blood glucose levels stable in conjunction with non-medical prevention and maintenance tactics. 

HOW TO MANAGE DIABETES AND DEMENTIA

What if your client or loved one has both diabetes and dementia? It’s a tough position: dementia makes it hard to manage diabetes, and diabetes can threaten the health and safety of people with dementia. 

People with dementia suffer a progressive worsening of their condition. They become disoriented, struggle with social situations, suffer from impaired reasoning, have difficulty making decisions, and can become unable to manage daily living skills. Eventually, in later stages, they can lose control of bodily functions and the ability to feed themselves. 

Obviously, a person with dementia will struggle to manage their own diabetes treatment. Whether it’s administering an insulin injection, testing for blood sugar levels and interpreting the results, remembering to get daily exercise and eat at appropriate intervals, or taking medications regularly, managing treatment requires lucidity and competence.  

There are other issues that can arise if a person develops diabetes while already suffering from dementia. They are at risk for developing incontinence from needing to use the toilet more often and being unable to find it. The frequent bathroom visits can also result in more falls, confusion can be worsened by dehydration, and stress levels may rise from changes in diet.

Whether your loved one has been living with dementia and has recently developed diabetes or the other way around, consider these tips for managing both: 

1: Educate yourself 

Knowing how to manage diabetes is vital. Turn to well-established organizations like Mayo Clinic, Alzheimer’s Association, and the American Diabetes Association for in-depth information you can trust. Many hospitals also offer education classes on both conditions.  

2: Manage nutrition

As dementia degrades memory, your loved one may forget to eat, eat too much, or become unable to recognize common foods. Make sure to have healthy foods on hand, label appropriate snacks, make sure water is available and sugary drinks are not, avoid eating out, and take other commonsense precautions to keep your loved one eating well. 

3: Get healthy together  

One way to encourage your loved one to eat well and exercise regularly is to do it together. Consider couching lifestyle changes as a way to spend more quality time with each other. 

4: Monitor glucose 

A cornerstone of diabetes management is monitoring glucose, which can be challenging in a person with dementia. Alarms and reminders can help. If your loved one becomes unable to stick their finger or even remember to do so, you may consider continuous glucose monitoring (CGMs), which track levels 24/7. 

5: Stay on top of medication 

Medication is a powerful way to keep diabetes under control but taking it improperly can be lethal. Make sure you are monitoring how and when your loved one takes their meds. Attend doctors’ appointments when you can and ask questions to be sure prescriptions won’t interact with other medications your loved one takes. A pill organizer can help, as can insulin pens with built-in memory functions. 

If you’re caring for a loved one with dementia and diabetes, you’re undoubtedly under an extreme amount of pressure. If you need help, reach out. Tender Rose provides expert, one-on-one care at home, exclusively for people with dementia. Our highly-trained Memory Care Professionals will help your client or loved one battle dementia and diabetes and win.