Diabetes and Dehydration
Put very simply, diabetes is a chronic disease in which excess sugar (glucose) builds up in the bloodstream. In order to reduce excessive glucose the kidneys, which are the organs in charge of this activity, ask the body for lots of fluid to dilute the glucose so that it can be processed. This fluid, which the body uses to process the excess glucose, eventually ends up being eliminated as urine.
When diabetics have a large amount of excess glucose, so much water is pulled from the body to process the glucose that the rest of the body system is often left without enough water to function properly.
This lack of water causes the increased thirst that is such a common symptom of diabetes. Increased thirst will normally lead to increased drinking and more frequent urination, which removes even more fluid from the body.
When the kidneys sense that the body is becoming too dry, they will ultimately begin to hold on to fluid rather than processing it out as urine. Unfortunately, holding on to this fluid also holds on to the excess glucose and other toxins that are processed by the kidneys, where they do progressive damage over time.
This vicious circle of dehydration is something that people with diabetes must keep a sharp eye on. Especially in the warmer months, when the heat increases the need for fluid, it is very easy for a diabetic to become dehydrated and experience a rise in the amount of sugar in the blood. This can become a vicious cycle that is difficult to break.
Because diabetics generally have more glucose (sugar) in their bodies than non-diabetics, they must make it a point to consume fluid on a regular basis, whether they "feel" thirsty or not. Water, of course, is the ideal fluid for hydration. However, any beverage that does not contain sugar or other carbohydrates is good for the purpose. Soups, gelatin, ice pops and sherbets also all contain water. Coffee and tea both contain caffeine, which can contribute to dehydration if consumed in large amounts. However, a glass of iced tea or a cup of coffee will usually provide more fluid than the caffeine will pull out, so they too are good for hydrating if used in moderate amounts.
Older diabetics can be even more susceptible to dangerous dehydration than younger people with diabetes. The elderly often do not feel thirsty when their bodies are first becoming dehydrated. Senior diabetics also often resist drinking a sufficient amount of water because trips to the bathroom can be difficult and tiring for older diabetics. Seniors who are not on fluid restriction because of other health issues will benefit from being encouraged to drink at every meal and on a regular schedule between meals.
If you notice that your older diabetic is more confused in the evening and at night, you might want to monitor their fluid intake during the afternoon and early evening. While frequent trips to the bathroom during sleeping hours can be disruptive, making sure that their blood sugar is under control and that they are drinking enough fluids can actually reduce the number of nighttime trips to the bathroom. It can also be helpful in reducing late day confusion and "sundowning" in diabetics who also have dementia.
The signs of dehydration can be different for each person. As a general rule, watch for any of these signs of dehydration. The person you are observing may or may not feel thirsty:
More tired or weak than usual
Frequent trips to the bathroom
Unusually dark urine
Breathlessness or fast breathing
Dry mouth and mucous membranes
Loss of appetite
Check the person's blood sugar immediately and take the measures recommended by your physician to reduce an elevated blood sugar. Seek medical attention immediately if you see disorientation, no urination for more than six or seven hours in spite of drinking fluids, severe diarrhea or vomiting, or any other symptom that seriously concerns you. Severe dehydration can be life-threatening.