If someone has dementia, family members, friends or carers may have to help with diabetes control. They may not have much experience of managing diabetes and they may be anxious about taking responsibility. 

The diabetes team at the surgery or hospital will be able to work with family and carers to make sure they learn the skills needed to help manage diabetes. This may be a stressful time with ups and downs, so carers and family will need to learn to manage high and low glucose levels and know what to do in an emergency. 

If someone has dementia, the targets of diabetes control can probably be relaxed. Someone with dementia may already be confused or less able to communicate how they’re feeling, so it may be more difficult to detect the symptoms of hypoglycaemia. Relaxing the targets reduces the risk of glucose levels dropping. 

It may also be worth considering simplifying the regime of glucose testing and frequency of insulin injections, especially if this causes significant distress. 

It’s extremely important to remember foot care. As people become more frail there is a much higher risk that skin will break, so it is really important for someone to check the feet of a person with diabetes and that appropriate footwear is worn to protect against ulceration. 

If a family member has concerns about someone’s ability to cope at home or self-manage their diabetes then they should seek professional help from the GP or diabetes team. It is often easier for a medical professional to be involved in these conversations as they can start to formulate a plan to provide some help.