How can a person worrying about where they’ll find the next meal, worry about what food that meal will include?
Yet for people experiencing homelessness who also have diabetes, the wrong diet can be life-threatening. With the right knowledge, however, homeless service providers and meal programs can help people with diabetes stay healthy during a time in their lives when so much else is chaotic and difficult.
What is Diabetes?
When a person has diabetes, the body isn’t creating the right amount of insulin, which regulates how sugar in the bloodstream is used and stored.
In Type 1 diabetes, the body cannot produce insulin and requires injections. In type 2 diabetes, which accounts for 90 percent of diabetes cases, it develops later is life and is usually connected to family history.
Complications of diabetes can be life-threatening, and include heart disease, kidney failure, infections, and circulatory problems.
It is important for shelter staff to recognize the signs of hypoglycemia to help people who are homeless diagnose diabetes and get the health support they need. Understanding the signs is tricky but important because hypoglycemic episodes can sometimes be confused with intoxication.
When suffering from an attack, a person with diabetes has low blood sugar which depletes the glucose needed by the brain. This can cause dizziness, headaches, blurred vision, poor coordination, fainting, tingling sensations in the lips or hands, confused speech, convulsions, and in the worst cases even loss of consciousness and coma. The release of hormones triggered by hypoglycemia can cause additional symptoms of tremors, sweating, rapid heartbeat, anxiety, and hunger.
Out of the 18 million individuals with diabetes in the U.S., 6 million don’t know they have it. If you see any of the above symptoms in a shelter resident, please recommend that they get tested for diabetes. Health Care for the Homeless in Minneapolis & Saint Paul does diabetes diagnostic assessments and screenings.
Food-Related Issues
Volunteer coordinators at meal programs play the crucial role in bringing in diabetes-friendly food. At a shelter where various church groups rotate cooking and bringing meals, the volunteer coordinator can provide a handout about good food options for people with diabetes.
The biggest diet-related problems for people with diabetes eating at meals programs include: excessive amounts of starch and sugars, relatively few fruits and vegetables, and large amounts of fat. Whenever possible, meals with fresh produce, less bakery items, and lower fats are better. Salads are a great option.
People with diabetes can also control their symptoms greatly by drinking more water and avoiding pop. It helps to bake meat in the oven instead of frying it. Even having alternative sweeteners, rather than just sugar, can make a difference.
If a food program is financially unable to change their options to accommodate people with diabetes, they can instead allow more flexibility in portions so that people with diabetes can take more of the vegetables and less starch.
Health Management Issues
Other complications besides food for homeless individuals with diabetes is treatment and control issues. Insulin therapy can be dangerous for people who can’t predict the number or timing of meals each day. Insulin storage also requires refrigeration. A shelter can help by offering their refrigeration for storage, or providing insulated lunch bags to keep them cool. They also need a safe way to clean and store needles, which are sometimes restricted because they are considered drug-related.
Diabetes is challenging for anyone to manage, but it is exceptionally challenging for people who have little control over their diet and their environment. With understanding and responsive staff, however, people experiencing homelessness with diabetes can get what they need to succeed.
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