Healthcare Focus: Diabetes

Image red writing reading the word "Diabetes".

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When faced with daunting routines involving insulin shots and strict diets, managing type 2 diabetes can be an overwhelming task for anyone. Homeless diabetics, however, inevitably have a more difficult time with the disease. 

In 2002m the Center for Disease Control and Prevention (CDC) reported that 18.2 million people in the United States have type 2 diabetes. Of that number, 5.2 million are not even aware that they have the disease and many are either living in poverty or are homeless. According to the CDC type 2 diabetes which causes sugar to build up in the blood, is the 6th leading cause of death in the United States. Typically, the hormone insulin helps keep blood sugar at a normal level. However, a diabetic’s body cannot produce insulin or the insulin it produces is defective. There are certain factors that may put a person at a higher risk for developing diabetes, including having a close relative with the disease or being of African-American, American-Indian, Asian-American, Pacific Islander, or Hispanic-American descent. Two of the most common risk factors include a sedentary lifestyle and lack of a well-balanced diet. The homeless are particular vulnerable to the latter factor. Homeless people, who face a lack of food choice and irregular mealtimes, cannot regulate their food intake in ways necessary to prevent or manage diabetes. 

Most homeless people, including diabetics, rely on shelters for the majority of their meals. However, shelters often provide high-fat, high-protein meals that generally are unsafe for diabetics. To further complicate matters, though most diabetics must administer their own insulin shots, many shelters don’t allow needles. In 2000, researchers reported in the Canadian Medical Association Journal that about 75% of homeless people with diabetes say that they have difficulties managing t heir disease. 

However, some shelters and homeless organizations are recognizing the needs of the growing population of homeless diabetics. For example, Amanda Garder of HealthScoutNews, reported in 2002 that even small changes, such as offering Sweet N’ Low or NutraSweet instead of sugar, can allow shelters to greatly help their diabetic clients.  

Also in 2002, the Health Care for the Homeless Clinicians’ Network released a report, Adapting Your Practice: Treatment and Recommendations for Homeless People with Diabetes Mellitus, specially geared towards helping clinics and homeless shelters assist people with diabetes. Among other recommendations, the report emphasized that homeless diabetics must take care of their feet. Diabetics who stand and walk for long periods of time are vulnerable to foot ulcers. The report also suggested that shelters encourage clients, especially diabetics, to wash their socks nightly and dry them thoroughly before putting them back on. In addition, homeless diabetics should examine their feet regularly to look for redness or open sores, and visit a clinic immediately if these symptoms occur.  

According to the Diabetes Research and Wellness Foundation, symptoms of diabetes include blurred vision, weight loss, frequent urination, excessive thirst, tiredness, slow healing cuts and sores, numbness or tingling in the hands and feet, increased hunger, and mood changes. Unfortunately, some diabetics do not feel the symptoms of high blood sugar or may attribute them to another cause. Many of the symptoms are not alarming or uncommon, but failure to notice them can have dangerous consequences. If you or someone you know is experiencing any of these symptoms, do not wait to schedule a visit to a medical professional for a simple blood test and potential diagnosis. 

Although there is no cure for diabetes, it is possible to live with the disease. Blood sugar levels can be controlled through careful food choices and proper medication. However, the first step to disease management is a diabetes diagnosis for a medical professional who can recommend proper treatment. Both shelters and homeless diabetics themselves can play a part in healing the homeless population tackle this hurdle and move forward. 

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