Hospice Care for End-Stage Diabetes

Diabetes affects nearly 12% of people in the United States, according to the Centers for Disease Control and Prevention (CDC).

End-stage diabetes, also known as late-stage diabetes, occurs when the disease progresses to a point where it significantly impacts the body's ability to function. This stage may involve complications such as chronic kidney disease, cardiovascular disease, nerve damage (neuropathy) and chronic infections.

These conditions can significantly reduce quality of life and may signal that it’s time to consider comfort-focused care options like hospice.

Understanding end-stage diabetes

Diabetes is a chronic condition that can lead to serious complications affecting multiple parts of the body. Over time, uncontrolled blood sugar often contributes to end-stage diabetic complications such as chronic kidney disease and cardiovascular disease. According to the American Diabetes Association, diabetes is the leading cause of chronic kidney disease, and among people with diabetes, cardiovascular disease is the leading cause of death.

While diabetes itself may not always be the sole cause of decline, its impact on the body can be profound. For example, high blood sugar levels can damage blood vessels, leading to poor circulation and wounds that don't heal. These complications can make the body weaker and increase vulnerability to infections and other serious health issues.

What are the signs and symptoms of end-stage diabetes?

Patients living with end-stage diabetes may experience a range of serious symptoms that signal the disease has progressed and may warrant hospice care. These symptoms often reflect the body's declining ability to heal, fight infection and regulate blood sugar.

• Rapid weight loss: Unexplained and significant weight loss may occur as the body struggles to process nutrients effectively and maintain energy.
• Recurring infections: A weakened immune system makes infections, such as urinary tract, skin or other infections more frequent and harder to treat.
• Non-healing wounds: Poor circulation and nerve damage (neuropathy) can lead to wounds that do not heal, increasing the risk of serious complications.
• Frequent hospitalizations: Severe infections, blood sugar crises, and complications involving the heart and kidneys can result in repeated hospital stays.
• Unmanageable blood sugar swings: As the body's ability to regulate insulin and blood sugar declines, patients may experience extreme highs and lows in blood sugar levels.

Recognizing these symptoms can help families and caregivers decide to explore comfort-focused care options that support quality of life.

How hospice care provides comfort for patients

Hospice care for patients with end-stage diabetes focuses on comfort and symptom relief rather than strict blood sugar control or long-term complication prevention. As the disease progresses, the goal shifts to reducing the burden of treatment while still honoring the patient's needs and preferences. For many, maintaining a simplified diabetes management plan can offer a sense of control and reassurance without adding unnecessary stress.

At VITAS, an interdisciplinary hospice team works closely with patients and their loved ones to create a personalized care plan that supports their goals and addresses their physical, emotional and spiritual needs. This may include specialized wound care to prevent infections, guidance on managing blood sugar symptoms, and education to empower families in providing day-to-day care and support. Families also receive counseling and guidance, helping them feel more confident and less alone during this deeply emotional journey.

When is hospice the right choice?

Hospice care may be the right choice when a patient with diabetes experiences end-stage diabetic complications and their life expectancy is six months or less. If you or a loved one has diabetes and are experiencing end-stage diabetic complications, contact VITAS to learn how hospice care can help.

常見問答

Is diabetes a terminal illness?

Diabetes is a chronic illness, not a terminal illness. Diabetes complications such as chronic kidney disease or cardiovascular disease can lead to end-of-life situations.

Does diabetes qualify for hospice care?

Patients with advanced diabetes and related complications may qualify for hospice care if their life expectancy is six months or less.

What is diabetic coma, and what does it mean?

Diabetic coma is a life-threatening condition caused by extremely high or low blood sugar levels. It requires immediate medical attention and may indicate the need for end-of-life care planning.