Front line education on diabetes involves educating the patient on the reason why they must take their medication regularly. The doctors perceive the patient is following the instructions and regularly taking their oral medications. When they return to the doctors for assessment and the result is not what is required, the doctor may say a higher dose needs to be given here. In some of the worst cases the patient may be asked to start insulin injections. The doctor thinks the patient has been taking the correct dose of tablets not realising the patient could have been regularly missing doses of oral medication. Front line educators the big question to diabetic patients is?
Do you take all of your diabetic medications as directed?
This question needs to be asked in a pleasant manner to enable the patient to feel they can open up and tell the truth and will not be judged. Days of the week trays and Nomad boxes could be very useful if the patient is forgetting to take a dose of medication.
This is so important and very often gets overlooked. As we age, sometimes high doses of medications are not the answer. Low dose can often be very effective especially in diabetes.
Creatinine clearance
Liver function test
Check your elderly diabetic patient has had both of the above tests recently, at least every 6 months.
Most countries have accepted the chronological age of 65 years as a definition of elderly. Other considerations a lot young people think anyone over 30 has passed their sell by date. The strange thing is it’s the one thing all humans have in common, they will get old unless they die earlier than expected. Numerous humans cannot discuss or embrace aging, yet there are many advantages if good health persists.
If the patient is sick or food intake is low, the oral hypoglycaemic medications must be looked at and may need to be reduced.
In general most of the older diabetic patients who have had the condition for 20 years or more are very confident at controlling their diabetes.