Support for diabetes management

Diet and nutritional support

There are many ways dietitians can support older people with diabetes, and they have invaluable advice for those learning to live with diabetes. Here, integratedliving Dietitian Meg details the top ones:

• How can a dietitian help in the management of diabetes for older adults?

  • They provide nutritional education on the role food plays in diabetes management.
  • Educate on carbohydrate or glucose-containing foods, and how these affect blood glucose levels (BGLs) when consumed.
  • Advise on what portions of carbohydrate foods should be consumed at meals (and snacks if required) based on several factors. These include an individual’s weight, physical activity levels, general wellbeing, and medication or insulin regime.
  • Ensure the Australian dietary guidelines (food groups and serves) are understood and being met.
  • Provide dietary recommendations and interventions that focus on healthy weight management, blood glucose level control, healthy cholesterol and blood pressure levels.
  • Educate on the prevention and treatment of hypoglycemia (low blood glucose levels) and discussing sick day management plans, i.e. what to do when appetite is poor or gastrointestinal symptoms, such as vomiting or diarrhoea, are present.
  • Provide tips for cooking / recipe modification, dining out or ordering takeaway, to promote healthy food choices.
  • Advise on food recommendations for occasions such as travel and holidays, during fasting or religious festivities.
  • Provide recommendations on, and assistance with, ordering diabetes specific supplements, i.e. for malnutrition, weight loss, wounds, texture modified diets, and enteral diets.
  • Provide personalised dietary education and meal plans for individuals experiencing diabetes and co-morbidities such as kidney disease, liver disease or coeliac disease.
    
    
    

• What are some dietitians’ tips for seniors with diabetes to manage their diet?

  • Follow the Australian dietary guidelines and consume foods from each of the five food groups, which are:
    
    
    1. Vegetables, beans and legumes 
    2. Fruits 
    3. Wholegrain breads, cereals, rice and pasta 
    4. Lean meats and poultry, fish, tofu/tempeh and unsalted nuts  
    5. Milk, yoghurt, cheese, or calcium fortified plant  alternatives 
       
       
  • Choose low-glycemic index carbohydrates, such as wholegrain breads, basmati rice and carisma potatoes.
  • Choose more wholefoods and less processed or packaged foods. 
  • Eat regular and balanced meals. 
  • Eat adequate serves of carbohydrates, spread evenly over the day. 
  • Consume mid-meal snacks as required, based on your medication or insulin regime. 
  • If choosing to consume alcohol, stick to the guidelines and have some alcohol-free days. 
  • Avoid foods high in saturated fats such as fried foods, baked goods, processed and cured meats, and foods made from coconut oil. 
  • Choose to cook with extra virgin olive oil.  
  • Flavour foods with a variety of herbs (such as oregano, rosemary, basil), or add garlic and lemon juice, rather than excess salt. 
  • Aim to have ‘meat-free Mondays’ or 1-2 evening meals per week in which meat is replaced with other protein-rich foods such as lentils, kidney beans, eggs, or tofu. 
  • Avoid sweetened beverages such as soft drink, juice, cordial or adding table sugar to hot drinks. 
    
    
    
    

Podiatry support

Did you know diabetes and foot health go hand-in-hand? Uncontrolled high blood sugar can reduce blood flow in your feet, leading to problems with cuts and sores healing. It makes sense then that podiatrists can assist with the management of diabetes. Here, integratedliving Podiatrist Rachel explains how podiatrists can assist older clients with the condition.

• How can a podiatrist help with the management of Diabetes for seniors?  

  • Assess and manage any nerve or sensation changes that start and can develop into neuropathy. Half of people with diabetes develop neuropathy, which is nerve damage leading to pain, weakness, numbness or tingling in parts of the body. This can affect a person’s ability to know their level of protective sensation. 
  • Assist with footwear and skin assessment to prevent issues like pressure or ulceration wounds that can develop as the foot changes with age and poorly fitting footwear.  
  • Ensure callous and corn removal to help prevent excessive pressure developing into breakdown and ulcerations.  
  • Assess circulation and monitor over time to see any changes, as poorer circulation can lead to complications and poor wound healing, as well as faster onset of neuropathy. 
    
    
    

• What are some tips for caring for your feet when someone has diabetes

  • Foot check: learn how to self-check.  
  • Seek footwear advice: including sock shoes and compression garments for oedema management. 
  • Education: Find out what signs or symptoms are cause for concern, keeping skin healthy, and what to do if fungal nails develop. 
  • See a podiatrist regularly: as a medical professional we see what you can’t, and catch mirror issues before the advance to major issues. 
    
    
    
    

Diabetes and Foot Wellness Program

At integratedliving, we also offer clients a Diabetes and Foot Wellness course under our Wellness for Independence Programs. This helps participants enhance their knowledge, and offers proactive lifestyle changes to teach senior people how to manage their diabetic condition effectively through diet, nutrition and foot care. 

Led by our Registered Nurses, the program supports clients to recognise the lifestyle factors that can affect diabetes as we age. It also provides essential information on how to recognise diabetes-related foot conditions.

Here, integratedliving Registered Nurse Fatimah tells us some of the benefits of the Program.

• What are some things that the Diabetes and Foot Wellness Program covers? 

  • The program covers types of diabetes, their symptoms, and blood glucose levels. It includes significant management topics such as exercise, good nutrition, as well as the importance of blood glucose monitoring and taking diabetes medication. The effects of diabetes to the body are also discussed, including diabetic emergencies such as hyperglycemia and hypoglycemia. 
  • The program also covers the importance of good foot health and best practice on how to look after your feet. In the foot sessions, we look at common ailments as well as foot pain. We discuss home safety and preventing the risk of foot injuries and falls.