Person-centred diabetes care

Diabetes is a common condition in older people. It occurs when there is too much glucose in the blood due to the body not making enough insulin or effectively using the insulin that it makes. In aged care, a person-centred approach to diabetes care is essential to living well. This month, we recognised World Diabetes Day on 14 November and want to share stories of inspiring practices in aged care.

Each person is unique

Everyone has individual needs and preferences, often based on their:

medical history
religious or cultural background
personal health goals

As people age, their bodies also change. How medicines work in the body will be different for each person. People’s appetite and physical activity levels will be different too. Providers must plan and develop diabetic care with individuals that is regularly reviewed.

Diabetes management in aged care needs to be safe, flexible and based on people’s needs, goals and preferences to achieve their best quality of life. In residential aged care, this could mean working with the older person and their multidisciplinary care team (including medical and allied health professionals) to talk about:

how often they have their blood sugar levels tested
what blood sugar level targets work best for them
changes to their medication
their personal sick day management plan.

There's no one best diet

Most people living with diabetes have heard the term ‘diabetic diet’ or been told they can’t eat certain foods. Strict diets may focus on limiting carbohydrates as well as sugar, salt and fat and may not be suitable for older people living with diabetes. This is because restricting food can lead to:

reduced quality of life
not eating enough
unplanned weight loss

Instead, the focus should be on providing individuals with balanced, nutritious and enjoyable meals that suit their personal preferences, culture and routines. You should work with the older person and their GP and dietitian to understand what may be best for them. Managing diabetes for older people should mean supporting them to make choices and live their best life.

Diabetes management in practice

Here's how some services are putting people at the centre of their diabetes care.

A Sydney residential care service demonstrated how they partner with older people and health professionals to provide a person-centred approach to diabetes management. One older person living at the service said that before they arrived, their food was restricted in hospital and that they weren't allowed desserts. The service's health professionals worked with them to adjust their medication and the timing of their meals, so they could still enjoy all their favourite foods.

In response to feedback from older people, a service in Victoria created a new menu that was available 24 hours a day, 7 days a week, with many nutritious snack options. Several older people living with diabetes were reported to have had more stable blood sugar levels after the menu was introduced, because they could choose a nourishing snack between meals.

At a residential care service in Queensland, one person felt that staff were checking her blood sugar levels too often and it was having a negative effect on her quality of life. She discussed her goals with her care team and that she wanted to be more independent. By working with medical and allied health professionals, the service supported her to have more control over her diabetes management. As a result, it was reported that her blood sugar levels improved. The change also had a positive effect on her self-esteem.