Diabetes and Disability Support: What Your Support Worker Can (and Can't) Do

Diabetes is one of the most common health conditions among NDIS participants, particularly those with physical disabilities or acquired brain injuries. If you're managing diabetes alongside your disability, you might be wondering: what can my support worker help with? Where's the line between support work and nursing care?

As a Certificate III qualified support worker in Melbourne's inner south, I'm trained in medication assistance—but there are clear boundaries around what I can and cannot do when it comes to diabetes management. Understanding these boundaries helps you build the right support team and stay safe.

The Clinical vs. Non-Clinical Divide

The key distinction in disability support work is between clinical tasks (which require a registered nurse) and non-clinical assistance (which qualified support workers can provide).

For diabetes management, this divide is particularly important because some aspects of diabetes care cross into clinical territory, while others are straightforward assistance with daily living.

What Support Workers CAN Do

With appropriate training and qualifications (like HLTHPS006 - Assist clients with medication), support workers can help with:

Oral diabetes medications: I can prompt you to take your diabetes tablets at the correct times, assist with opening medication packaging, hand you your pre-filled Webster pack or blister pack, and document that medication was taken as scheduled.

Meal preparation for diabetes management: I can prepare meals following your diabetes meal plan or dietitian's recommendations, measure portions according to your carbohydrate counting guide, prepare foods to appropriate consistency if you have swallowing difficulties, and ensure regular meal times to support blood sugar stability.

Blood glucose monitoring assistance: Without specific nurse delegation, I can hand you your blood glucose meter, remind you to test at scheduled times, read the meter result if you have vision impairment, and document the reading. However, with proper training and delegation from a registered nurse as part of your diabetes management plan, support workers can also perform the fingerstick blood glucose test itself. In either case, I cannot interpret what the reading means or make clinical decisions about dose adjustments—that remains nursing or medical decision-making.

Recognizing hypoglycemia symptoms: I'm trained to recognize signs of low blood sugar (sweating, shaking, confusion, dizziness) and can prompt you to check your blood glucose or consume fast-acting carbohydrates if you're experiencing symptoms. In an emergency, I would call 000.

Supporting your diabetes routine: I can help you maintain the daily routines that support diabetes management—regular meal times, grocery shopping for diabetes-appropriate foods, accompanying you to endocrinologist appointments, and assisting with foot care and hygiene (which is crucial for diabetes management).

What Support Workers CANNOT Do Without Nurse Delegation

The following tasks are generally outside the scope of disability support work, though some can be performed with specific training and delegation from a registered nurse under your care plan:

Insulin injections: By default, administering insulin via injection or insulin pen requires nursing qualifications. However, according to NDIS guidelines, support workers can be trained and delegated by a registered nurse to administer insulin as part of a participant's diabetes management plan. This requires documented training, competency assessment, and clear protocols.

Insulin pump management: Adjusting insulin pump settings, changing infusion sets, or troubleshooting pump issues requires specialized nursing knowledge and is outside support worker scope.

Blood glucose interpretation and dose adjustment: While I can read and document the number on your meter, I cannot tell you how much insulin to take or whether to adjust your medication based on the reading. This requires clinical judgment and remains nursing or medical decision-making regardless of delegation.

Managing diabetes emergencies: While I can call 000 and provide basic first aid, managing severe hypoglycemia with glucagon injections or handling diabetic ketoacidosis requires emergency medical response.

Building Your Diabetes Support Team

If you have diabetes and need support with daily living, you might need a combination of services:

Your support worker (like me) can assist with meal preparation, medication prompting for oral medications, maintaining routines, grocery shopping, and attending appointments with you.

A registered nurse is essential if you need insulin administration, dose adjustments based on blood glucose readings, wound care for diabetic ulcers, or management of complex diabetes with multiple complications.

Your GP and endocrinologist provide your diabetes management plan, prescribe medications, and make clinical decisions about your treatment.

A dietitian creates your meal plans and carbohydrate counting guides, which your support worker can then follow when preparing meals.

Many NDIS participants with diabetes have both a support worker for daily assistance and nursing support for insulin administration. The NDIS funds these differently—support work comes from your Core Supports budget, while nursing is usually funded under Capacity Building or may require additional health supports.

The Meal Preparation Advantage

One area where support workers can make a significant difference for diabetes management is meal preparation. Consistent, appropriate nutrition is foundational to diabetes control, but preparing diabetes-friendly meals takes time, planning, and energy.

I can work from your dietitian's meal plan to prepare meals that support stable blood glucose levels. This might include measuring carbohydrate portions, preparing low-GI foods, ensuring regular meal timing, cooking methods that reduce added fats and sugars, and preparing meals in advance if you struggle with consistent cooking due to fatigue or mobility limitations.

For many participants managing diabetes alongside disability, the exhaustion of meal preparation can lead to skipped meals or reliance on less healthy convenience foods—both of which destabilize blood sugar. Having consistent support with meal preparation can genuinely improve diabetes outcomes.

Hypoglycemia Recognition: A Critical Support Worker Skill

While I can't treat hypoglycemia with medical interventions, recognizing the signs of low blood sugar is a crucial safety skill for any support worker supporting someone with diabetes.

During personal care or community access sessions, I'm trained to watch for symptoms like sudden sweating, trembling or shakiness, confusion or difficulty concentrating, irritability or mood changes, pale skin, dizziness or lightheadedness, hunger, and rapid heartbeat.

If you experience these symptoms and you're capable of self-managing, I can prompt you to check your blood glucose and consume fast-acting carbohydrates (glucose tablets, juice, regular soda) as per your diabetes management plan. If you become confused, unresponsive, or unable to self-manage, I would call 000 immediately.

This is why having the same support worker consistently—rather than rotating agency staff—matters for diabetes safety. I become familiar with your baseline, recognize when something's off, and know your specific diabetes management plan.

Diabetes and Personal Care

Diabetes affects many aspects of personal care, and this is where support workers play an important role:

Foot care: Diabetes increases the risk of foot complications, so daily foot inspection and proper hygiene are critical. I can assist with washing and drying feet thoroughly, checking for cuts, blisters, or changes, applying moisturizer (avoiding between toes), and ensuring proper footwear. Any wounds or concerns would be documented and you'd be encouraged to see your GP or podiatrist.

Skin care: Diabetes can cause dry skin and slow wound healing. During showering and bathing assistance, I pay attention to skin integrity, ensure thorough drying (especially in skin folds), apply prescribed creams or moisturizers, and alert you to any areas of concern.

Oral hygiene: Diabetes increases the risk of gum disease. Assistance with thorough tooth brushing, flossing, and denture care helps prevent complications.

Timing of personal care: If you take diabetes medication that affects timing (like insulin with meals), we can schedule personal care sessions to accommodate your medication routine—for instance, not scheduling morning personal care so early that it interferes with breakfast and morning medication.

Community Access and Diabetes Safety

When providing community access support—whether that's attending appointments, social outings, or recreational activities—diabetes safety is always a consideration.

I ensure you have access to your blood glucose meter and testing supplies, fast-acting carbohydrates in case of low blood sugar, your medication if we'll be out during scheduled times, water to stay hydrated, and appropriate snacks if the activity is longer or more physically demanding than usual.

If we're going out for a meal, I can help you make menu choices consistent with your diabetes management plan. If you're attending a medical appointment where fasting is required, we can plan the timing to minimize the risk of hypoglycemia.

Documentation and Communication

When supporting someone with diabetes, clear documentation and communication are essential. After each support session, I document any diabetes-related observations: whether medications were taken as scheduled, blood glucose readings (the number, not my interpretation), meals consumed and approximate portion sizes, any symptoms of high or low blood sugar, and any concerns or changes from your usual baseline.

This information can be valuable for your diabetes management team and helps ensure continuity of care. If you're self-managed or plan-managed under the NDIS, you have control over who receives this documentation and how it's shared.

When to Add Nursing Support

If you currently manage your own insulin but are finding it increasingly difficult due to vision changes, dexterity issues, or cognitive changes, it might be time to discuss nursing support with your NDIS plan manager or support coordinator.

Signs you might need nursing support added to your plan include difficulty drawing up accurate insulin doses, trouble with injection technique or site rotation, frequent blood glucose readings outside your target range, missed insulin doses due to forgetting or difficulty administering, or wounds that aren't healing properly.

Having both a support worker and nursing support isn't duplication—they serve different functions. I provide the consistent daily assistance with meals, routines, and non-clinical aspects of diabetes management. A nurse provides the clinical interventions you can't safely do yourself.

Questions to Ask Potential Support Workers

If you have diabetes and you're interviewing support workers for personal care, domestic assistance, or community access in Melbourne's inner south, ask these questions:

Do you have medication assistance training? Look for HLTHPS006 certification, which covers the legal and safe administration of oral medications.

Have you supported participants with diabetes before? While I'm newer to disability support work, my Certificate III training included diabetes awareness, hypoglycemia recognition, and meal preparation for specific dietary needs.

Can you follow a diabetes meal plan? Make sure your support worker is comfortable with carbohydrate counting, portion control, and preparing diabetes-appropriate meals.

Do you know the signs of hypoglycemia? This is basic safety knowledge every support worker supporting someone with diabetes should have.

What would you do if my blood sugar was very low? The correct answer involves prompting you to consume fast-acting carbohydrates if you're alert, and calling 000 if you're confused or unresponsive—not attempting to administer glucagon or make clinical decisions.

Living Well with Diabetes and Disability

Managing diabetes alongside disability presents unique challenges, but with the right support structure, it's absolutely possible to maintain good blood glucose control and prevent complications.

The key is understanding where different supports fit: clinical nursing for insulin and medical decision-making, support workers for daily assistance that keeps your diabetes routine consistent, allied health professionals for specialized diabetes education and meal planning, and your own knowledge and self-advocacy as the expert on your body and your needs.

If you're self-managed or plan-managed under the NDIS in South Yarra, Prahran, Windsor, or surrounding inner south suburbs, I can provide the non-clinical diabetes support that helps you maintain your independence and health. But I'll also be honest about what's outside my scope and when you need nursing involvement.

That honesty is part of providing safe, ethical support. Diabetes management has clear clinical boundaries, and respecting those boundaries keeps you safe while maximizing what support workers can genuinely help with.

Related Resources

• Meal preparation and domestic assistance services
• Personal care support including foot care and hygiene
• Understanding NDIS funding categories for different support types
• Diabetes Australia - Diabetes management resources
• Contact me to discuss your specific support needs