Diabetes Management in Assisted Living

Licensed California assisted living facilities are able to accept residents with diabetes if certain requirements are met. In the same vein, a resident of an assisted living community who develops diabetes while residing in such a facility is also permitted to stay under certain conditions. In this article, we provide an overview of diabetes management in assisted living. 

Overview of Diabetes

The U.S. Centers for Disease Control and Prevention defines diabetes as:

Diabetes is a chronic health condition that affects how the human body turns food into energy.

The body breaks down most of the food you eat into sugar, technically known as glucose. Glucose is then released into a person’s bloodstream. When blood sugar goes up, it signals your pancreas to release insulin. Insulin acts like a key to let the blood sugar into your body’s cells for use as energy.

With diabetes, the human body doesn’t make enough insulin or can’t use it as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems of different types that are discussed later in this article. 

There are three types of diabetes:

  • Type 1 diabetes
  • Type 2 diabetes
  • Gestational diabetes

Type 1 diabetes is thought to be caused by an autoimmune reaction. In other words, the body attacks itself by mistake. This reaction stops your body from making insulin. Approximately 5-10 percent of the people who have diabetes have Type 1. Symptoms of Type 1 diabetes often develop quickly. This type of diabetes usually diagnosed in children, teens, and young adults. If you have type 1 diabetes, you’ll need to take insulin every day to survive. Currently, no one knows how to prevent Type 1 diabetes.

Type 2 diabetes results in your body not using insulin well. Your body cannot keep blood sugar at normal levels. About 90-95 percent of individuals diagnosed with diabetes have Type 2. It develops over many years and is usually diagnosed in adults (but recently, more and more often in children, teens, and young adults). You may not notice any symptoms. Therefore, it is important to get your blood sugar tested if you’re at risk. Type 2 diabetes can be prevented or delayed with healthy lifestyle changes. These include:

  • Losing weight
  • Eating healthy food
  • Being active

Gestational diabetes impacts some women when they are pregnant. This type of diabetes can impact the health and wellness of an unborn baby. Moreover, gestational diabetes puts a woman at a heightened risk of someday developing Type 2 diabetes. 

An alarming 33 percent of the U.S. population has what medically is known as prediabetes. More than 80 percent of individuals in the country with prediabetes do not know they have this condition. With prediabetes, blood sugar levels are higher than normal, but not high enough for a Type 2 diabetes diagnosis. 

With that said, prediabetes raises a person’s risk for:

  • Type 2 diabetes
  • Heart disease
  • Stroke.

Lifestyle changes can lessen the risk that prediabetes will progress into Type 2 diabetes. In addition, it is possible (for some individuals) to lower blood sugar levels and move out of a prediabetic state. 

Regulations Associated With Residents With Diabetes in a California Assisted Living Community

In the state of California, a licensed assisted living community is able to retain or accept a resident with diabetes under certain circumstances. Keep in mind that an assisted living community has the discretion to retain or accept an individual with diabetes as a resident, but is not required to do so by state law or regulation. 

In order for an assisted living community in California to be able to retain or accept a resident with diabetes, the individual with the disease needs to meet these criteria:

  • A resident or prospective resident with diabetes must be able to perform his or her own glucose testing (with either blood or urine samples)
  • A resident or prospective resident with diabetes must be able to administer his or her own medication (orally or by injection)

The assisted living community itself must be able to satisfy four criteria in order to retain or accept a resident diagnosed with diabetes:

  • Assist residents with the self-administration of medications
  • Ensure sufficient amounts of:
    • Medications
    • Testing equipment
    • Testing supplies
    • Syringes
    • Needles
  • Ensure that needles and syringes are disposed of in the manner prescribed by applicable regulation (and associated law)
  • Provide resident with diabetes modified diets as prescribed by that resident’s physician 

Complications of Diabetes

A person with diabetes can experience a variety of complications which can prove to be very serious. This particularly is the case if diabetes is not appropriately managed. The primary complications that can arise when an individual is diagnosed with diabetes include:

  • Cardiovascular disease. Diabetes significantly increases the risk of different types of heart problems. These can include:
    • Coronary artery disease with chest pain
    • Heart attack
    • Stroke
    • Narrowing of arteries 
  • Nerve damage. Too much sugar in a person’s system can injure the walls of the tiny blood vessels (also known as capillaries) that nourish the nerves. This particularly is the case in the legs and feet. This can result in tingling, numbness, burning, or pain that usually begins at the tips of the toes or fingers and then gradually spreads upward. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea, or constipation. For men, nerve damage caused by diabetes may lead to erectile dysfunction.
  • Kidney damage.The kidneys hold millions of tiny blood vessel clusters that filter waste from the blood. Diabetes can damage this delicate filtering system and result in a number of different types of serious health complications. 
  • Eye damage. Diabetes can damage the blood vessels of the eye. This is known as diabetic retinopathy. Ultimately, this condition has the potential to result in blindness.
  • Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of many foot complications of different types.
  • Skin and mouth conditions. Diabetes may leave you more prone to skin problems, including bacterial and fungal infections.
  • Hearing impairment. Hearing problems are quite common place in people diagnosed with diabetes.
  • Alzheimer’s disease. Type 2 diabetes may increase the risk of dementia, including Alzheimer’s disease.
  • Depression. Depression symptoms are common in people with type 1 and type 2 diabetes.