to accommodate episodes of increased activity
(for example, wandering) or refusal of food.
Achieving this safely depends on the competency
of the carers involved with the person and requires
comprehensive training and supervision.
The first statement in the NICE QS1 document
recommends that all people with dementia be
looked after by staff who have been appropriately
trained, and it gives a list of what this should entail
(NICE, 2010). Additional skills are required if
the individual also has diabetes (TREND-UK,
2011; 2013). People with both conditions are
vulnerable and have very complex needs, yet
they may be living in care homes with staff
who have inadequate training. NICE (2013b)
also recognises that these people may have poor
access to NHS services, including a GP, and gives
recommendations to address this.
Conclusion
Type 2 diabetes and dementia are increasingly
common as they are both associated with
increasing age and, as people become older, they
are more likely to have both conditions. This has
significant implications for self-management
of diabetes and also safety when using agents
that cause hypoglycaemia. Thoughtful use of
medications and agreeing appropriate glycaemic
targets, comprehensive training of carers and
the development of dynamic care plans that
incorporate residual self-management skills are
some of the aspects of care that diabetes nurses
will be involved in when caring for people with
diabetes and dementia.