How to safely manage diabetes at home

More than 4.9 million people in the UK have diabetes, and managing the condition can seem incredibly demanding at times. Diabetes can affect people’s muscle mass and eyesight, and increase the likelihood of having a fall.

But there are many practical steps you can take to improve your chances of living a safe, independent life at home, such as having the right support and encouragement – from a partner, friend or someone from your healthcare team.

Below, we explore insights and tips to support you in managing diabetes at home.

What is diabetes?

We all need the hormone insulin to live. It does the essential job of allowing glucose in your blood to enter your cells and fuel your body.

In type 1 diabetes, the body attacks the cells in your pancreas that make insulin, meaning you can’t produce any at all. People with type 1 diabetes need to regularly monitor their blood sugars and inject insulin to prevent their blood sugars becoming dangerously high.

When you have type 2 diabetes, the insulin your pancreas makes doesn’t work properly, or your pancreas can’t make enough insulin. This means your blood sugar levels keep rising. Some people control their type 2 diabetes with diet and exercise, while others take medication such as metformin tablets or insulin injections.

Research has shown that for some people, combined lifestyle interventions – including diet, physical activity and sustained weight loss – can put type 2 diabetes into remission. This means your blood sugars stay in the healthy range for the long term, without you taking any diabetes medication.

Over time, high blood sugar levels can damage parts of your body, including your feet and eyes. These are called diabetes complications. With the right care and support, you can take action to prevent or delay many of these.

Man sitting and smiling as he takes his blood sugar level

How to better understand diabetes

When you live with diabetes, or care for someone who does, there’s a lot to learn. But getting to grips with your condition and how to manage it is key to living well and avoiding complications.

People who enrol on a diabetes education course often feel more confident about managing their diabetes, making healthier food choices and looking after themselves. These courses are all designed to be friendly and informal, and they aren’t just for the newly diagnosed. You can ask to go on a course however long you’ve had diabetes. They give you the opportunity to meet peers, and you can learn face-to-face or online.

If you’re supporting someone with diabetes, you can usually attend as well. Ask your doctor or nurse about free diabetes education courses in your area.

The charity Diabetes UK has an online education service called Learning Zone, which has been designed for people who can’t get onto an education course. It has practical advice from the experts and tips from people who have been there too.

Managing your diet and activity

Eating a healthy, balanced diet, being active and maintaining a healthy weight can help you manage your blood sugars and assist you in living independently with diabetes.

Being physically active helps with balance, circulation, controlling blood sugars and lowering cholesterol and blood pressure. It can also help with coordination and reduce the risk of falls. The NHS Fitness Studio has a range of online workout videos, created by fitness experts, for people to do at home.

Many people with diabetes can move around easily, but if you have issues with physical mobility, there are a number of ways you can incorporate exercise into your daily or weekly routines. Here are some tips to help you get started:

  • Regular 30-minute periods of walking or wheeling a wheelchair can be an excellent basis for a physical activity programme.
  • Stretching exercises can help improve your range of motion. Consider activities such as Tai Chi, yoga or Pilates.
  • Swimming or aqua aerobics can be an excellent activity if you’re unable to comfortably walk or wheel.
  • Upper body exercises can help build strength. Diabetes UK has a free, downloadable poster featuring five ways to move more while you’re sitting down, plus a video of simple arm movements you can do at home sitting down or standing up.

One way to look at these activities is that they are insurance for the future. People who have diabetes are at greater risk of feeling the effects of sarcopenia – a loss of muscle mass later in life – which can cause frailty and a lack of coordination, balance and strength.

When researchers from Liverpool Hope University recently assessed the benefits of weight-based exercise in later life, they reported ‘incredible’ improvements in muscle strength. And any activity that builds muscle strength helps improve insulin sensitivity, which is important when you live with diabetes.

Check out the Diabetes UK website for free exercise video and activity suggestions.

Woman doing crunches on exercise mat in front of her laptop at home

Use technology to help get your diabetes under control

FreeStyle Libre glucose monitors and continuous glucose monitors (CGMs) enable you to check your sugar levels without pricking your fingers.

You can wear a small sensor on your body day and night that reads your levels and you can see that information on your mobile phone, or other device. If someone helps you to look after your diabetes, their mobile can be linked up too.

With a CGM and the FreeStyle Libre 2, you can also set an alarm to sound if your sugar levels get too low or too high. This can also be set up to sound on someone else’s mobile – for example, a carer’s.

One of the other main benefits of FreeStyle Libre and CGMs is being able to review what your sugar levels do every minute of the day and night. With the charts and graphs, you can start to see and understand how food, activity, and other things affect your sugar levels.

If you have a learning disability and use insulin, you should be offered a FreeStyle Libre glucose monitor under NICE guidelines for England and Wales.

Adults with type 2 diabetes in England or Wales who use insulin and would otherwise need help from a care worker or healthcare professional to monitor their blood sugar should be offered a FreeStyle Libre glucose monitor. 

In Scotland, national guidelines recommend that people who manage their diabetes with multiple daily injections or insulin pump therapy should have access to FreeStyle Libre glucose monitoring.

Find out more about who qualifies for a CGM flash pump on the NHS

Attending your regular healthcare checks

When you have diabetes, you’re entitled to certain checks, tests and services to help you manage your condition and get the care you need. These help prevent serious diabetes complications, such as problems with your feet, eyes, heart and kidneys.  

During the pandemic, many people with diabetes had routine appointments cancelled or postponed, or they were held over the phone or by video call instead. If you haven’t had an appointment at all for your diabetes in the last 12-18 months, contact the doctor or team responsible for your diabetes care.

An HbA1c test checks your average blood sugar levels for the last two to three months.

Knowing your HbA1c level, and what you can do to lower it if it’s too high, will help you reduce your risk of diabetes complications. This means getting your HbA1c checked regularly.

You’re entitled to an HbA1c test at least once a year. If it’s high or needs a little more attention, the check will be done every three to six months. It’s really important not to skip these tests, so if you haven’t had one for more than a year, contact your healthcare team.

Your feet should be checked once a year to see if you’ve lost any feeling, and for ulcers and infections. This can be done by your GP, diabetes nurse or a podiatrist. It’s important to wear well-fitting shoes that don’t rub and to check your feet yourself every day. Speak to your GP immediately if you have cuts, bruises or numbness in your feet.

Your eyes should be checked every year for damaged blood vessels, which can cause sight problems – diabetic retinopathy – and blindness. Treating damaged blood vessels early can prevent sight problems. Speak to your GP immediately if you have blurred vision, especially at night, shapes floating in your vision (floaters) or sensitivity to light.

Your GP or diabetes nurse should also check for high blood pressure, and heart and kidney disease, at least once a year.

Female doctor smiling as she listens to a male patient opposite

Safety around the home

People with diabetes can face many challenges throughout their lifetime, including problems with mobility and a high risk of falls.

Falls can be a concern for people with diabetes, especially for older people and those living with neuropathy. Low blood sugars and some medications can also affect mobility or lead to unsteadiness and loss of balance.

Walking barefoot or in socks indoors has been shown to increase the risk of falls in older people. When you have diabetes, it’s important to wear well-fitting shoes and it’s also a good idea to wear shoes with low heels and firm slip-resistant soles inside the house.

Identifying risks around the home can also help you avoid trips and falls. Common causes of falls include:

  • Poorly organised and cluttered walkways
  • Inadequate lighting
  • Moving or handling a load incorrectly
  • Rushing around
  • Tiredness
  • Physical ability, lack of mobility or lack of balance
  • Poor eyesight
  • Medication that can lead to dizziness
  • Small rugs or rugs on top of carpets
  • Low and soft chairs
  • Slippers, high-heeled shoes, non-gripping soles and barefoot walking
  • Heavily patterned carpets

Signing up to support services can also help you to feel safer at home. Services like the Priority Services Register (PSR) can help you to access the best possible services at all times if you experience interruptions to your gas supply or utilities. This is a free service to help people in vulnerable situations, and people who live with diabetes are eligible to be added to the PSR.

Understanding your sick day rules

When you have diabetes, it’s important to know how to cope when you’re unwell. These are known as ‘diabetes sick day rules’.

Part of your body’s defence mechanism for fighting illness and infection is to release glucose into the bloodstream. This can raise your blood sugar to dangerously high levels, even if you’re off your food or eating less than usual. Meanwhile, feeling or being sick, or having diarrhoea, can make your blood sugar levels drop because you’re not absorbing food as usual.

When you’re unwell, it’s important to keep taking your diabetes medication, even if you don’t feel like
eating. However, if you take a certain type of diabetes tablet called SGLT2i you should stop taking them as they could increase your risk of developing dangerously high blood sugar levels. Diabetes UK advises that
“if you take SGLT2i and become ill, you need to check your ketones and your blood sugars, and speak to your
healthcare team.”

Check your blood sugar at least every four hours, including during the night. Stay hydrated, and eat little
and often. Make sure you talk to your diabetes team or speak to a local pharmacist, so they can give you the
right advice.

If you have type 1 diabetes, it’s important to check for ketones when you’re unwell. Ketones are a type of chemical that your liver produces when it breaks down fats. If they are present, it’s a sign that something isn’t right. If you find ketones, it’s essential to contact your diabetes team.

Further reading

Additional support at home

The Priority Services Register (PSR) is a free service, designed to support those who need a little extra help in the event of interruptions to their gas, water or electricity supply.

If you or someone you know has extra communication, access or safety needs, signing up to the PSR will help you to access the best possible services at all times and to feel safe and independent at home.

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