Diabetes End-of-Life Signs
When it comes to treating diabetes at the end-of-life, the goal of hospice care is to keep the patient as comfortable as possible, rather than focusing on trying to keep glucose levels within the target range. While individuals are admitted to hospice with the diagnosis of diabetes, it’s more common that diabetes is part of a comorbidity, meaning the patient has diabetes but also has other life-limiting diseases and secondary conditions.
Even so, caregivers should know the diabetes end-of-life signs, as well as what complications may arise.
What are the signs of end-of-life due to diabetes?
Both type 1 and type 2 diabetes at the end-of-life can lead to several complications. Recognizing whether a patient has the symptoms of high or low blood glucose can help avoid complications. If you recognize any of the following end-of-life diabetes signs, please contact the patient’s primary care physician or hospice care provider.
Signs of high blood glucose include:
- Using the bathroom frequently
- Increased drowsiness
- Infections
- Increased thirst
- Increased hunger
- Itching
- Weight loss
- Fatigue
- Numbness in fingers/toes
- Wounds that are slow to heal
Signs of low blood glucose include:
- Feeling irritable or anxious
- Trembling and sweating
- Paleness
- Palpitations
- Blurred vision
- Sweating
Tips for managing end-of-life Diabetes symptoms.
Keeping blood glucose levels within the target range may be difficult at the end of life and therefore is not as much of a priority. Instead, managing the end of life for a diabetes patient should focus on comfort.
At this stage, the patient’s pertinent symptoms of any ailment should be managed. Keeping blood sugar within a certain range is not a priority. In the final days of life, diabetic ketoacidosis (DKA) can develop quickly and can result in a diabetic coma. It’s important to consider the preferences of the patient and their level of consciousness when deciding whether to continue insulin therapy.
What you can do for your loved one.
Being present for your loved one in their time of need is one of the most important things you can do. Sometimes just being a comforting presence to your loved one is enough. As a family caregiver, you can also make sure to pay attention for the signs of end-of-life diabetes and report them to your loved one’s medical service providers. It may be helpful to understand hospice eligibility requirements to see if your loved one can start benefitting from improved quality of life now.
How hospice can help with end-stage Diabetes.
Hospice supports patients and their loved ones by providing many services that help satisfy their physical, emotional, and spiritual needs. For patients experiencing the diabetes end-of-life signs, our hospice teams provide expert pain, symptom, and medication management to ensure the patient’s comfort during the final stage of their life. Many diabetic patients and their families also find hospice helpful when making decisions about medical care.
The Crossroads team consists of doctors, nurses, aides, social workers, and volunteers ready to help. If you would like to learn more, please call 855-327-4677 at any time for help or contact us online.
Common Questions About Diabetes at the End of Life
Do patients with diabetes qualify for hospice care?
While diabetes alone generally does not meet the criteria for hospice care, when diabetes is present alongside another serious illness, the two conditions together may reduce a patient’s life expectancy to less than six months if the illnesses follow their normal course.
Will I get to keep my insulin while in hospice care?
When the body isn’t making or using insulin correctly, a physician may prescribe insulin shots to help control a patient’s blood sugar. If left untreated, elevated blood sugar levels can cause long-term complications.
However, as the patient approaches end of life, diabetes management begins to focus on controlling the immediate symptoms of low and high blood sugar instead of trying to avoid long-term complications. For example, if the patient is eating less while still taking their standard dose of insulin, they may experience the troubling effects of low blood sugar including sweating, heart palpitations, blurry vision, hunger, trembling, irritability, or anxiety.
Type 1 diabetics will generally need to continue their insulin, although it may be reduced based on their meal intake. Patients with Type 2 diabetes in hospice care will have their medication reviewed and they may be able to stop taking insulin as high blood sugar at end of life will not cause additional complications, and low blood sugar symptoms caused by continuing to take insulin can cause additional discomfort.
Each patient’s medication list will be reviewed to determine the best combination of medication for their current condition. Medication that only provides a long-term benefit may be discontinued if the patient only has a short time left to live, while additional medications that provide an immediate benefit to the patient’s comfort and quality of life may be added.
Could your loved one benefit from hospice care?
End-of-Life signs by disease.
Learn about the specific end-of-life signs of common diseases and illnesses: