t is easy to think about concussions when watching sports: especially football, ice hockey, and soccer. We have seen an increase in awareness and attention to the prevention and treatment of concussions in sports, but do you ever think about the effect of a concussion on diabetes self-management?
I am fortunate to work in a major hospital that has an amazing concussion management program. I see people of all ages in physical and occupational therapy for treatment of post-concussion symptoms. They are also seen by other practitioners, including physicians, psychologists, a rehabilitation counselor, and others depending on their needs. This has heightened my awareness of the possible impact of concussions on many facets of an individual’s life, including diabetes management.
The management of post-concussion syndrome should start with a comprehensive evaluation by the appropriate healthcare professionals who specialize in concussion care
When I see a person with diabetes for self-management education and hear things like, “I have trouble remembering to check my blood glucose or take my medication,” or “I just don’t have the energy to exercise or cook healthy meals,” or “I am just not motivated to do all of this stuff for my diabetes,” and find that they have suffered a head injury (from a sport, a fall, a motor vehicle accident (MVA), etc.), I think about post-concussion syndrome. I can refer a person to the concussion management program where they can get the interventions and support they need. The team will work with the person on specifics of their life, including the activities that are part of their diabetes care. This may involve finding strategies to remember to take medication, to check blood glucose and to adjust exercise and physical activity to an appropriate amount (generally less, to avoid being overly fatigued).
Here are some interesting facts about concussions:
- Concussions are a mild traumatic brain injury resulting from a blow or jolt to the head.
- Some people lose consciousness but others are just dazed or confused.
- The most common causes of concussion are MVAs, falls, assaults and sports injury.
- The onset of symptoms is variable, starting right away or after days or weeks.
Symptoms can include:
- Headache, neck pain
- Lack of energy, feeling physically and mentally tired
- Nausea, dizziness, light-headedness and a loss of balance
- Blurred or double vision and sensitivity to light
- Increased sensitivity to sounds or ringing in the ears
- A change in sleep patterns
- Difficulty concentrating and paying attention, trouble with learning and memory, being easily confused and losing track of time and place
- Being slower in thinking, acting, reading and speaking
- Lack of organization in everyday tasks
- Mood changes, decreased motivation, being easily overwhelmed and more impulsive and disinhibited
Think about how many of these symptoms could affect diabetes self-management.
The management of post-concussion syndrome should start with a comprehensive evaluation by the appropriate healthcare professionals who specialize in concussion care. Treatments include education about how to manage symptoms; guidance on when to return to various activities and when to rest; referrals to various services and professionals; and collaboration of care with the family, coach, employer and/or school personnel.
As diabetes educators, we can help to facilitate the best care for individuals who have had a concussion and are struggling with the many tasks involved in diabetes self-management by referring to programs and providers who specialize in this area.
About the Author
Karen Kemmis is a physical therapist, exercise physiologist, certified diabetes educator, and also holds certifications in Pilates for rehabilitation and exercise for aging adults. She is based out of SUNY Upstate Medical University in Syracuse, NY and splits her time between a Joslin Diabetes Center affiliate, an outpatient rehabilitation department, and a PT program where she is an adjunct professor.