07/05/2011 04:19 pm ET Updated Sep 04, 2011

Addressing Diabetes Care in the Home

When people think of caregiving, they envision a middle-aged woman providing loving care for her elderly mother who lives in a nursing home. In reality, a caregiver can be a relatively youthful spouse whose husband or wife has a chronic condition -- such as diabetes -- that requires daily monitoring.

Diabetes is a condition in adults and children that occurs when the body cannot properly convert glucose (sugar) into energy. According to the American Diabetes Association, approximately 26 million adults and children in the United States are living with diabetes, and another 79 million people have pre-diabetes (a condition that increases their risk for developing Type 2 diabetes).

There is no cure for diabetes, a disease that affects approximately a quarter of American adults over age 60 (which is why it's become a significant health issue). When it comes to managing diabetes, people have to factor in costs, diet, exercise, medications, other illnesses and more. This means there are many couples in which one of them has to become a caregiver for the other as the disease progresses.

Sally and Gary Herigstad are one such couple. Gary was diagnosed with diabetes four years ago. Now it's up to Sally to be part wife, part in-home caregiver as they both try to stay on top of his diabetes.

"I don't worry about what food costs anymore," said Sally Herigstad of Kent, Washington, whose husband, Gary, was diagnosed with diabetes four years ago. "Ten dollars for a bag of almond flour? I'll take two. It's a bargain compared to out-of-control diabetes."

Mrs. Herigstad's husband is among the millions trying to control his Type 2 diabetes with diet and exercise. "Not one cookie has passed his lips since his blood sugar results were 298," she said. The good part is that he can keep his blood sugar down most of the time just by controlling carbs and exercising like a madman."

Type 1 diabetes occurs when the body does not make insulin and Type 2 diabetes is the more common form and is related to obesity and poor nutrition. Older adults have a higher risk for Type 2 diabetes. To find out if you or someone you love is at risk or has symptoms of diabetes, visit the American Diabetes Association website.

Diet and exercise are perhaps the most important factors in avoiding Type 2 diabetes and living a healthy life with diabetes.

"Creating a home health strategy that includes good nutrition is of high importance," says Homewatch CareGivers, a national in-home caregiver agency. "Senior exercise and assistance with meals are a part of the care that we can provide for people with living with diabetes -- and it makes a big difference."

Linda Haas, an endocrinology nurse specialist and clinical nurse advisor at the U.S. Department of Veteran Affairs, advises that people living with diabetes choose a healthy lifestyle and not one of forbidden temptations.

"We don't tell folks living with diabetes that they can't have sugar," she said. "Everything needs to be done in moderation."

One woman with Type 1 diabetes said that for people diagnosed with Type 2 diabetes later in life, the dietary changes can feel like "swimming upstream" at first.

And when it comes to exercise, Haas said that she isn't talking about competing in triathlons, but rather, something as simple as movement while sitting for those with arthritis and other painful conditions. Simply walking regularly can make a difference in one's health. Again, moderation and consistency are the key to maintaining a healthy diet and weight -- and keeping diabetes under control.

Learn more about proper nutrition and get tips on low-glycemic foods in this article.

For the Herigstad's, the diabetes diagnosis has altered their social lives. "We don't go to social events where he won't have anything to eat," Mrs. Herigstad said. "Or we eat beforehand."

However, when it comes to daily in-home meals, the Herigstad's are following experts' tips to make it a way of life. "I can make a low-carb version of almost anything," Mrs. Herigstad said. "When you start a program like this, you think and talk about it a lot, but as the years go by, you burn out that way. It has to just be on autopilot -- this is the way we cook now. There are no days off, no exceptions."

People with diabetes are also at greater risk for a number of illnesses including kidney disease, heart disease, stroke, blindness and according to the Diabetes Association of America, over 60 percent of non-traumatic lower limb amputations occur in people with diabetes.

"For older people with diabetes, adequate foot care is important," said Haas. "If they can't see their feet or reach the bottoms of their feet they need to have them examined daily." She suggested using a mirror for those people who live alone. Because diabetes can cause a numbing in the limbs, people with diabetes may not feel a cut or injury to their foot and are therefore more likely to be unaware of an infection, Haas explained.

Experts agree that people with diabetes need to create a team of professionals , friends and family members to help address all of needs associated with the condition.

"Living with diabetes day in, day out can be difficult," notes the Mayo Clinic staff. "Sometimes, even when you've done everything right, your blood sugar levels may rise. But stick with your diabetes management plan and you'll likely see a positive difference."