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Dealing with diabetes

March 01 2020
There is no diabetes outreach service for people who are homeless, but diabetes specialist nurse Judith Kennon, who is based in Glasgow, has some tips to keep you healthy

There are two main type of diabetes: Type 1 and Type 2. Both cause your blood sugar levels to rise higher than what’s considered to be normal.

Eating regularly
Insulin and some of the oral medications used to help lower blood sugar readings will put you at risk of low blood sugars. This is called hypoglycaemia. Not having a regular supply of food and/or drinking alcohol can put you at risk of low blood sugars.

Signs and symptoms of low blood sugars are feeling shaky, dizzy or hungry; headaches, sweating and acting drunk.

A blood sugar reading less than 4 is classed as a “hypo”. These should be treated with something sugary such as 4-5 jelly babies or 200ml fruit juice/Lucozade or Glucogel or 5 Glucose tablets. Once you have taken something sugary it’s important to re-check your blood sugar reading, about 10 minutes later, to make sure it has come back up above 4. If it hasn’t then you need to eat again.

TIP from the street:
prevent another hypo with carbs from biscuits, sandwiches and toast.

One of the big risks of drinking alcohol and having diabetes is that alcohol will cause your blood sugar readings to drop. If you are drunk, then you may not notice your blood sugars are low. For this reason, it is a good idea to let people around you know that you have diabetes and to carry some form of diabetes ID. It is also a good idea to keep a snack on you. 

Very severe hypos can lead to comas and require medical attention and admission to hospital.

The balancing act between making sure that your blood sugars don’t go too high or too low can be difficult, particularly if you don’t have access to food. For this reason, you should be given a blood glucose monitor which is a machine that measures the sugar in your blood. There should be someone who can teach you how to use this and help you learn what numbers to aim for.

If you have type 1 diabetes your blood sugar meter should also allow you to check for something called ketones. Ketones are a chemical that your body produces when it has to burn fat for body energy. This can happen when you do not get enough to eat as your body relies on food for energy so when it doesn’t get it, it starts to use up any fat stores that you might have instead. 

In diabetes, the main cause for ketones is lack of insulin which can result in ketones building up in the bloodstream. High levels of ketones in the body can be toxic and in type 1 diabetes can lead to diabetic ketoacidosis (DKA).

Signs of DKA include vomiting, stomach pains, breath that smells like pear drops or nail varnish remover, breathing quickly/ struggling to breathe and loss of energy. If left untreated DKA is very serious and can lead to a diabetic coma or death. Anyone with these symptoms should contact the nearest A&E as soon as possible.

In a nutshell

  • If you have diabetes or your blood sugars are high you will be thirsty, need to pee more often, be tired, lose weight.
  • Type 1 diabetes: the pancreas has lost its ability to make a hormone called insulin. Insulin is needed to get sugar out of your blood and into your cells for energy. Someone with type 1 diabetes needs to take insulin injections to help the sugar levels in their blood.
  • Type 2 diabetes: your body can still produce insulin, but the insulin can’t work properly. The insulin isn’t always able to enter the cells because of “insulin resistance”. Most people with type 2 diabetes are given advice on diet and lifestyle changes and their high blood sugars are often managed with tablets, although some end up on insulin injections if their blood sugars remain high.
  • Your GP or diabetes hospital team can help you manage your diabetes.
  • In an emergency call 999.
  • Find info at Diabetes UK and Diabetes Scotland visit Questions? Tel: 0345 123 2399.