Navigating Diabetes Management with Professional Home Care Services, Inc.

Share this article:

Living with diabetes requires diligent management, and at Professional Home Care Services, Inc., we understand the complexities involved. Our dedicated team of home health nurses is here to provide the support and education you need to thrive. This article will explore the different types of diabetes, the crucial role of insulin, and the two primary methods for monitoring glucose levels, highlighting how our nurses can empower you in your diabetes journey.

Understanding Diabetes

Diabetes mellitus is a chronic metabolic disorder characterized by elevated blood glucose (sugar) levels. This occurs when the body either doesn’t produce enough insulin or can’t effectively use the insulin it produces. Insulin, a hormone made by the pancreas, acts like a key that allows glucose from the food we eat to enter our cells for energy. When this process is disrupted, glucose builds up in the bloodstream, leading to various health complications over time.  

There are several main types of diabetes:

• Type 1 Diabetes: This is an autoimmune disease where the body’s immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. People with Type 1 diabetes produce little to no insulin and require daily insulin injections or an insulin pump to survive. It’s often diagnosed in children and young adults but can occur at any age.  
• Type 2 Diabetes: This is the most common type of diabetes. In Type 2 diabetes, the body either doesn’t produce enough insulin, or the cells become resistant to the insulin that is produced (insulin resistance). This often develops gradually over many years and is frequently associated with lifestyle factors such as excess weight, physical inactivity, and genetics.  
• Gestational Diabetes: This type of diabetes develops during pregnancy in women who didn’t have diabetes before. It usually resolves after the baby is born, but women who have had gestational diabetes have a higher risk of developing Type 2 diabetes later in life.  
• Prediabetes: This is a condition where blood glucose levels are higher than normal but not yet high enough to be diagnosed as Type 2 diabetes. Many people with prediabetes go on to develop Type 2 diabetes, but lifestyle changes can often prevent or delay this progression.  

The Role of Insulin in Diabetes Treatment

For individuals with Type 1 diabetes and many with Type 2 diabetes, insulin therapy is essential for managing blood glucose levels. Since their bodies either don’t produce enough or can’t effectively use the insulin they make, external insulin is needed to help glucose enter the cells for energy.

Different types of insulin are available, each with a different onset (how quickly it starts working), peak (when it’s most effective), and duration (how long it lasts):

• Rapid-acting insulin: Starts working within 15 minutes, peaks in about 1-2 hours, and lasts for 2-4 hours. Examples include Humalog (insulin lispro), Novolog (insulin aspart), and Apidra (insulin glulisine). It’s often taken just before or after meals to cover the rise in blood glucose from food.
• Short-acting (Regular) insulin: Starts working within 30 minutes to 1 hour, peaks in 2-3 hours, and lasts for 3-6 hours. An example is Humulin R or Novolin R. It’s typically taken 30 minutes before a meal.
• Intermediate-acting insulin: Starts working within 2-4 hours, peaks in 4-12 hours, and lasts for 12-18 hours. Examples include NPH (Humulin N, Novolin N). It’s often taken once or twice a day to provide background insulin coverage.
• Long-acting insulin: Starts working within a few hours and provides a relatively steady level of insulin for up to 24 hours or longer, with no significant peak. Examples include Lantus (insulin glargine), Levemir (insulin detemir), Toujeo (insulin glargine U-300), and Tresiba (insulin degludec). It’s typically taken once a day to provide basal insulin.
• Ultra-long-acting insulin: Such as Tresiba, can last for more than 24 hours, providing a very stable basal insulin level.
• Premixed insulin: These are combinations of different types of insulin, such as a rapid-acting or short-acting insulin mixed with an intermediate-acting insulin (e.g., Humalog Mix 75/25, Novolog Mix 70/30). They offer convenience for some individuals.

The specific type and dosage of insulin prescribed depend on individual needs, lifestyle, and blood glucose patterns.

Monitoring Glucose Levels: A Key to Diabetes Management

Regularly monitoring blood glucose levels is crucial for effective diabetes management. It helps individuals understand how food, activity, stress, and medications affect their blood sugar and allows for timely adjustments to insulin doses or other treatment strategies. There are two primary methods for monitoring glucose:

1. Traditional Blood Glucose Meter (BG Meter)

• Definition and Explanation: A blood glucose meter is a portable electronic device that measures the level of glucose in a small sample of blood, typically obtained by pricking a fingertip with a lancet. The blood is then applied to a test strip that is inserted into the meter, and the device displays the blood glucose reading within seconds. Popular brands include Accu-Chek, OneTouch, and Contour.
• Pros:
  • Affordability: BG meters and test strips are generally less expensive than continuous glucose monitoring systems.
  • Portability and Ease of Use: BG meters are small, lightweight, and relatively simple to operate.
  • Accuracy for Point-in-Time Readings: When used correctly, BG meters provide accurate blood glucose levels at the moment of testing.
  • No Insertion Required (for the device itself): Only a small finger prick is needed for each test.
• Cons:
  • Provides Only a Snapshot: Each reading only reflects the blood glucose level at that specific moment and doesn’t show trends or patterns over time.
  • Requires Frequent Finger Pricking: Multiple daily tests can be uncomfortable and inconvenient for some individuals.
  • May Miss Overnight or Between-Meal Fluctuations: Because testing is usually done at specific times, significant blood glucose swings outside of those times may go unnoticed.

2. Continuous Glucose Monitoring System (CGM)

• Definition and Explanation: A continuous glucose monitoring (CGM) system is a device that continuously tracks glucose levels in interstitial fluid (the fluid just beneath the skin) throughout the day and night. It consists of a small sensor inserted under the skin (usually on the abdomen or arm), a transmitter that sends glucose data wirelessly, and a receiver or compatible smartphone app that displays the real-time glucose readings and trends. Popular brands include Dexcom, Abbott FreeStyle Libre, and Medtronic Guardian. Some CGMs, like the Dexcom G7 and Abbott FreeStyle Libre 3, offer real-time continuous readings without the need for routine fingerstick calibration (though some older models or situations may still require occasional calibration).
• Pros:
  • Real-Time Glucose Readings: Provides continuous, up-to-the-minute glucose levels, offering a comprehensive picture of glucose fluctuations.
  • Trend Arrows and Graphs: Shows the direction and rate of glucose changes, allowing for proactive adjustments to prevent highs and lows.
  • Alerts and Alarms: Can be set to warn users when their glucose levels are going too high or too low, even when they are sleeping.
  • Reduced Need for Fingersticks: Many newer CGMs eliminate or significantly reduce the need for routine fingerstick calibration.
  • Data Sharing Capabilities: Allows users to share their glucose data with healthcare providers and caregivers remotely.
• Cons:
  • Higher Cost: CGMs and their sensors are generally more expensive than BG meters and test strips.
  • Requires Sensor Insertion: Inserting the sensor under the skin can be a concern for some individuals.
  • Potential for Skin Irritation: Some people may experience skin irritation or allergic reactions at the sensor insertion site.
  • Accuracy Can Be Affected by Certain Medications or Conditions: While generally accurate, CGM readings can sometimes be influenced by certain medications or dehydration.

How Home Health Nurses Assist with Glucose Monitoring

Our skilled home health nurses at Professional Home Care Services, Inc. play a vital role in educating and assisting clients with both traditional BG meters and continuous glucose monitoring systems. Their support ensures clients can confidently and accurately monitor their glucose levels as part of their diabetes management plan.

Here are some ways our nurses can help:

• Education and Training: Providing thorough instructions on how to use each type of monitor correctly, including proper technique for obtaining a blood sample for BG meters and sensor insertion and maintenance for CGMs.
• Troubleshooting: Assisting with any technical issues or alarms from the devices and helping clients understand the meaning of their readings and trends.
• Interpretation of Results: Helping clients understand their blood glucose readings and CGM data in the context of their overall health, diet, activity, and medication regimen.
• Integration with Insulin Administration: Guiding clients on how to use their glucose monitoring data to inform their insulin dosing, in accordance with their physician’s orders.
• Identifying Patterns and Trends: Working with clients to recognize patterns in their glucose levels and identify factors that influence them.
• Communication with Healthcare Providers: Sharing glucose monitoring data with the client’s physician and other healthcare team members to facilitate informed treatment decisions.

Real-Life Examples of Nurse Support

Here are three examples of how our home health nurses have assisted clients with glucose monitoring:

1. Assisting with Initial BG Meter Training: Mrs. Davis, a new client with Type 2 diabetes, was overwhelmed by her new blood glucose meter. Our nurse visited her home, patiently explained each step of the testing process, demonstrated proper finger-pricking technique, and helped her understand how to record her results. The nurse also created a personalized testing schedule that fit Mrs. Davis’s daily routine, increasing her confidence and adherence to monitoring.
2. Troubleshooting CGM Alarms: Mr. Johnson, who recently started using a Dexcom G6 CGM, was frequently experiencing high glucose alarms overnight and felt anxious. Our nurse reviewed his CGM data with him, helped him identify potential causes related to his evening meal and bedtime routine, and collaborated with his doctor to adjust his evening insulin dose. The nurse also educated Mr. Johnson on how to interpret the trend arrows and proactively manage his glucose levels, leading to fewer alarms and improved sleep.
3. Integrating CGM Data for Insulin Adjustments: Ms. Rodriguez, who has Type 1 diabetes and uses an Abbott FreeStyle Libre 2, was struggling to fine-tune her insulin doses around exercise. Our nurse worked with her to analyze her CGM data before, during, and after her walks. By identifying patterns of post-exercise hypoglycemia, the nurse, in consultation with Ms. Rodriguez’s endocrinologist, helped her adjust her pre-exercise insulin and carbohydrate intake, allowing her to exercise safely and maintain better glucose control.

Empowering Insulin Compliance with Glucose Monitoring

At Professional Home Care Services, Inc., our home health nurses recognize that consistent glucose monitoring is a cornerstone of effective insulin therapy. By providing comprehensive education, ongoing support, and expert guidance on both traditional BG meters and advanced CGM systems, we empower our clients to:

• Understand the impact of their lifestyle choices on their blood glucose levels.
• Administer their insulin with greater confidence and precision based on real-time data.
• Proactively manage fluctuations in their glucose to prevent hyperglycemic and hypoglycemic events.
• Collaborate effectively with their healthcare team to optimize their diabetes management plan.

Our commitment is to provide compassionate and skilled care that enables individuals with diabetes to live healthier, more independent lives in the comfort of their own homes. If you or a loved one needs support with diabetes management and glucose monitoring, please contact Professional Home Care Services, Inc. We are here to help you navigate your journey with confidence.