Safe diabetes care for an older adult at home comes down to five daily tasks: finger-prick checks as the doctor prescribes, tablets or insulin on time and at exactly the number of units prescribed, meals that match the medicine, a foot check, and watching for low blood sugar. In older adults, low blood sugar often shows up as confusion, drowsiness, slow speech or a fall rather than a racing heart and sweating. If the reading is 70 mg/dL or lower and your parent is awake and able to swallow, give about 15 grams of fast-acting sugar and recheck in 15 minutes. If they are unconscious or cannot swallow, give nothing by mouth and call 1669 immediately.
Many families start to worry the day the doctor says, "It's time to start insulin." A nurse demonstrates for a few minutes at the hospital, and then the family takes over. The questions keep coming. Must the pen stay in the fridge? Is injecting the belly every day a problem? Dad ate very little this morning; should he still get the usual injection? Or one afternoon Mum speaks slowly and answers the wrong question, and everyone assumes she is sleepy when it may be low blood sugar. This guide gathers what families need as steps and checklists you can use today. The figures are general guidance from Thailand's 2023 clinical practice guideline for diabetes; your parent's doctor may set different targets, so always follow the doctor first.
Quick answer
- Five daily tasks: finger-prick checks as prescribed, medicine or insulin on time, meals on time, a foot check, and watching for low blood sugar
- The number of insulin units must follow the doctor's prescription only. Never increase or reduce it yourself
- Keep unopened insulin in the main fridge compartment at 2–8°C and never freeze it; keep insulin in use at room temperature no higher than about 30°C, usually for no more than 28 days; check the package leaflet
- Inject into the abdomen, thighs, upper arms or buttocks, moving about two finger-widths from the last spot every time
- Sugar of 70 mg/dL or lower and able to swallow: give 15 g of fast sugar and recheck in 15 minutes. Unconscious or unable to swallow: nothing by mouth, call 1669
- Check the feet daily, test foot-washing water with your elbow and keep it no warmer than 35°C, and see a doctor promptly about any wound
1. Five daily tasks for families caring for an older adult with diabetes
Diabetes care at home is manageable once you break it into five daily tasks and keep one logbook that everyone uses.
- Finger-prick checks on the doctor's schedule. Some parents test every day, others only on certain days. Follow the doctor on how often and when.
- Tablets or insulin on time and in the right amount, according to the latest prescription. If the doctor changes anything, update the logbook straight away.
- Meals on time and matched to the medicine. After insulin or sugar-lowering tablets, your parent must eat at mealtimes; skipping or delaying a meal raises the risk of low blood sugar. For suitable foods, ask the doctor or a dietitian.
- A daily foot check. A small wound on the foot can go unnoticed until it becomes a big problem.
- Watching for low blood sugar, especially after injections, before meals and on days your parent eats little.
What to write in the logbook
A complete logbook helps the doctor adjust medicine and shows anyone covering for you what happened today.
- Date, time and sugar reading, noting before or after a meal
- Tablets and insulin given: type, units as prescribed, and injection site
- How much your parent ate: all, half, or nothing
- Anything unusual: drowsiness, confusion, dizziness, a fall
- How the feet looked that day
If your parent takes several medicines, a proper medication system means fewer missed or repeated tablets; see setting up a medication system for older adults at home.
2. Finger-prick blood sugar checks step by step, and how to read them
A reliable finger-prick reading starts with clean, dry hands, a prick on the side of the fingertip, and writing the result down straight away with the time.
- Prepare the meter, test strips, lancing device with lancet, tissues and logbook. Check the strips' expiry date.
- Have your parent wash their hands with soap and warm water and dry them thoroughly. Wet hands or traces of sweet food can distort the reading.
- If the hands are cold, let the arm hang down for a moment or gently massage from the base of the finger towards the tip.
- Insert a test strip as the meter's manual describes.
- Prick the side of the fingertip, which hurts less than the centre, and use a different finger each time.
- Touch the drop of blood to the strip without squeezing the finger hard.
- Read and record the result immediately, with the time and whether it was before or after a meal.
- Put used lancets in a hard plastic bottle with a lid, not in the ordinary rubbish.
The number everyone at home must remember is 70 mg/dL or lower, which means low blood sugar: follow section 5 at once. Your parent's target range, and how high a reading should prompt a call, are for the doctor to set; write them on the front of the logbook, because targets differ between older adults. If a reading is much higher than usual, wash hands and test again before drawing conclusions. If it is 70 or lower, always treat the low first.
3. Storing insulin so it stays effective
Unopened insulin belongs in the main fridge compartment at 2–8°C and must never be frozen. A vial or pen in use is kept at room temperature no higher than about 30°C, away from sunlight and heat, and is usually good for no more than 28 days; some types last longer, so check the package leaflet for the type your parent uses.
Unopened insulin
- Store in the main fridge compartment at 2–8°C, not in the freezer and not against the coldest part of the fridge
- If it has accidentally frozen, do not use it even after thawing; ask a pharmacist about a replacement
Insulin in use
- Keep at room temperature no higher than about 30°C, away from sunlight and heat: not on top of the fridge, next to the stove, on a windowsill or left in the car
- Rooms without air conditioning in Thailand can get warmer than this in the afternoon, so choose the coolest spot in the home and ask the pharmacist how to store it in your situation
- Write the opening date on the vial or pen and count the days allowed in the package leaflet
- Look at the insulin before each use; if it looks different from usual, ask the pharmacist
- If your parent uses more than one type of insulin, store them separately with clear labels to avoid mix-ups
4. Where to inject insulin, and how to rotate injection sites
Insulin can be injected into four areas: the abdomen, thighs, upper arms and buttocks. The abdomen is the preferred area; inject about two finger-widths away from the navel, and move about two finger-widths away from the previous spot every time.
An easy rotation system
- Divide the abdomen into four sections around the navel (upper left, upper right, lower left, lower right), leaving about two finger-widths clear around the navel
- Use one section at a time in order, moving about two finger-widths from the last spot each time
- Record every injection site in the logbook so whoever gives the next injection does not repeat it
- Never inject into the same spot repeatedly: absorption becomes poor and fatty lumps form under the skin
- Do not rub or massage after injecting
- Avoid lumps, wounds and bruises
Checklist before every injection
- Wash your hands
- Check the insulin name and type on the label match this time of day
- Check the expiry date and the opening date you wrote
- Set the units exactly as prescribed; if someone else is present, have them read it back
- Is your parent's meal ready for the time the doctor specified?
- Inject using the technique the nurse or pharmacist taught
- Put the needle in a hard plastic bottle with a lid
The number of insulin units must follow the doctor's prescription only, even if today's reading is higher or lower than usual. Never increase or decrease it yourself. If the doctor has given you a written sliding-scale chart, follow that chart and nothing else; otherwise, record the reading and call the doctor or nurse.
5. Low blood sugar in older adults: the easily missed signs and the 15-15 rule
Low blood sugar means a finger-prick reading of 70 mg/dL or lower. Older adults may not have an obvious racing heart or sweating; instead they may become confused, drowsy, speak slowly, behave differently or fall. If your parent is awake and able to swallow, treat it at once with the 15-15 rule.
Signs that should make you think of low blood sugar
- Confusion, answering questions wrongly
- Unusual drowsiness, hard to wake
- Slower speech than normal
- A change in usual behaviour
- A fall without a clear reason
- A racing heart or sweating, which older adults may or may not have
When in doubt, check the blood sugar straight away. Do not assume your parent is "just sleepy" or "forgetful with age".
The 15-15 rule, step by step (only if your parent is awake and can swallow)
- Check the sugar. At 70 mg/dL or lower, start treatment immediately.
- Give about 15 grams of fast-acting sugar, choosing one of: 180 ml of fresh orange juice, 180 ml of regular sugared soft drink (not the sugar-free kind), 3 teaspoons of honey, or 1 tablespoon of sugar dissolved in water.
- Have your parent sit and rest, wait 15 minutes, and check again.
- If it is still below 70, give another 15 grams of fast sugar and check again.
- Once the reading has risen and they feel better, give the next meal or a snack.
- Record the episode in the logbook and tell the doctor so the medicine can be reviewed.
Milk and bread act more slowly, so they are not the first step; they can be the snack once the sugar is back up. Keep a "low sugar kit" at home: fresh orange juice or a sugared soft drink with a glass marked at 180 ml, honey with a teaspoon, and the 15-15 steps taped by the fridge. Take a small kit whenever your parent goes out.
When to call 1669
- Your parent is unconscious, cannot be woken, or cannot swallow: give nothing by mouth, because they may choke, and call 1669 immediately
- Sugar has been given again but they are not improving, or they are becoming steadily drowsier
Calling 1669 is free and available 24 hours a day. Prepare your parent's conditions and medicine list before anything happens; see our emergency plan and guide to calling the 1669 ambulance.
6. Daily foot care for older adults with diabetes
The feet of an older adult with diabetes need checking every day, because a small wound nobody sees can get worse. If your parent's eyesight is poor or they cannot reach their feet, this becomes a job for the family.
- Wash the feet daily and dry carefully between the toes
- Check the feet and nails daily for wounds, redness, swelling, calluses and ingrown nails, using a mirror for the soles
- Avoid walking barefoot, indoors or outdoors
- Test warm water with your elbow every time; it should be no warmer than 35°C
- Never use a hot water bottle or heating pad on the feet
- Cut nails following the natural edge, not deep into the corners
- If you find a wound, see a doctor promptly rather than watching it for days
7. Sick days, poor appetite or vomiting
On days your parent is unwell, eating little or vomiting, call the doctor or nurse at once about that day's medicine and insulin. Do not decide by yourself to stop the medicine, cut the units or give the usual amount.
Have this ready before you call:
- The latest sugar reading and when it was taken
- What your parent has managed to eat and drink today
- Other symptoms, such as vomiting, diarrhoea or fever
- Medicines and insulin used, including the most recent round already given
Through the day, check the sugar as the doctor advises, encourage frequent sips of water and watch more closely for low blood sugar. If your parent becomes drowsy, is breathing hard, or cannot keep anything down, go to hospital or call 1669.
Mistakes families often make
- Adjusting units to today's reading. Sugar may go too low or too high. Follow only the prescription or the doctor's chart, and call when unsure.
- Always injecting the same convenient spot. Absorption suffers and fatty lumps form. Rotate and record sites.
- Keeping an opened pen somewhere hot, or in the freezer. The insulin may lose effect. Follow section 3 and the leaflet.
- Assuming your parent is just sleepy or forgetful. It may be low blood sugar. Test whenever behaviour changes suddenly.
- Treating a low with milk, bread or a sugar-free drink. Sugar rises slowly or not at all. Use fast-acting sugar per the 15-15 rule.
- Giving a sweet drink to a parent too drowsy to swallow. They may choke. Nothing by mouth; call 1669 at once.
When to bring in a professional team
If no one is home at injection times, poor eyesight or shaky hands make setting the units impossible, a low has already caused a fall or drowsiness, several conditions mean complicated medicines, or a foot wound has appeared, the work is exceeding what the family can manage. If you want to continue on your own, the first free option is to ask the hospital nurse or pharmacist to teach the injection again until everyone is confident.
- A caregiver trained in insulin injection. Insulin injection is one of the specially trained care tasks. KIN HomeCare assigns a caregiver (nursing assistant) who has completed training for that task, under the supervision of our registered-nurse team, alongside daily care such as meals and medicines on time, vital signs, hygiene and foot checks, watching for low blood sugar and keeping the logbook for the family. The price is the same as a standard caregiver: a 12-hour shift is 1,800 baht per day or 30,000 baht per month (one day off per week; 36,000 baht with no days off), and a 24-hour live-in caregiver is 2,500 baht per day or 36,000 baht per month (41,000 baht with no days off). See elderly care at home. A simple rule of thumb: care tasks the hospital teaches families to continue at home can be done by a caregiver trained for them.
- A registered nurse suits parents with several conditions, complex medicines or a foot wound. A doctor must see any wound first; the nurse then cares for it at home following the doctor's plan. A 12-hour registered-nurse shift is 3,500 baht per day, wound dressing is 1,200 baht per visit, and a nurse home visit is 1,800 baht. See home nursing and comparing the cost of a home nurse and a caregiver.
Frequently asked questions
Where can insulin be injected?
Into four areas: the abdomen, thighs, upper arms and buttocks. The abdomen is preferred, about two finger-widths from the navel, moving about two finger-widths from the previous spot each time. Do not rub after injecting.
How many units of insulin should be injected?
Only the number the doctor prescribes. The number of units differs from person to person and the doctor may adjust it based on the readings in your logbook. Never increase or reduce it yourself unless the doctor has given you a written sliding-scale chart.
How long can insulin be kept out of the fridge?
Insulin in use can be kept at room temperature no higher than about 30°C, away from sunlight and heat, usually for no more than 28 days; some types last longer, so check the package leaflet. Unopened insulin must stay in the main fridge compartment at 2–8°C and must not be frozen.
What should you do when an older adult has low blood sugar?
If the reading is 70 mg/dL or lower and your parent is awake and can swallow, give about 15 grams of fast sugar, such as 180 ml of fresh orange juice or 3 teaspoons of honey, and recheck in 15 minutes. If still below 70, repeat with another 15 grams. If they are unconscious or cannot swallow, give nothing by mouth and call 1669.
How many times a day should an older adult with diabetes check blood sugar?
As often as the doctor prescribes. It depends on the tablets, the type of insulin and your parent's condition; some test every day, others only on certain days. Ask the doctor for a clear schedule and write it on the front of the logbook.
Can you inject insulin and then skip a meal?
No, because it risks low blood sugar. If your parent cannot eat, eats very little or is vomiting, call the doctor or nurse before that injection. Do not decide on your own whether to give the usual amount or skip it.
Can a caregiver give insulin injections?
Yes, if it is a caregiver who has completed training for that task, under the supervision of our registered-nurse team. Insulin injection is a specially trained care task, and at KIN HomeCare it costs the same as a standard caregiver. Other injections are the work of a registered nurse.
Talk to the KIN HomeCare team
If your parent has just started insulin, or there is no longer anyone at home at injection times, tell the team how many times a day your parent has finger-prick checks and injections, whether they have other conditions, and which hours are uncovered. We will help you decide whether a caregiver trained for that task is enough or whether a registered nurse should be involved.
- Elderly care at home and registered nurses: 061-881-9399 (+66 61 881 9399)
- LINE @KINHOMECARE
- Free consultation, caregiver profiles to view first, and care usually starts within 2–3 days
- Home care available nationwide; travel costs depend on the area and are confirmed by staff before booking
- See all our rates on the pricing page
This information is general guidance for families and does not replace advice from the doctor caring for your parent.
Prepared by the KIN HomeCare team · Prices as of September 2026; please confirm with our staff before booking.
