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Effects of blood glucose levels on performance in activities of daily living: a case example of a diabetic man with an acquired brain injury.

Dysfunctional blood glucose regulation and sequelae of acquired brain injury (ABI) can affect behavioural training in brain injury rehabilitation. The relationship is examined between blood glucose levels and performance in three activities of daily living (ADL) skills (showering, toileting, and dressing) in a 21-year-old male with ABI and Type I diabetes mellitus. Multiple daily glucometer readings were obtained both pre- and post-treatment. Skills training involved graduated prompting and reinforcement to develop independence in ADLs. Assessment and teaching occurred initially in hospital, and then was presented at home. Results show a strong negative relationship between daily fluctuations in blood glucose levels and performance; no relationship was found between daily mean levels and performance. Implications for treatment approaches for diabetic individuals with ABI are discussed.