Mum – Hypos/Diabetes

[Auntiep]

Mum has had a couple of hypos today, and each time it’s taken a lot of sugar (glucose tablets, sweet drinks etc) to get her blood glucose level above 4 again. She had a hype even though she had some dinner this evening, and then had another tonight. It’s made me wonder, does dementia affect diabetes?

I was a little concerned when the district nurse still went ahead and administered her insulin when her level was quite low. Also she didn’t wait 10 minutes and test again before saying to give Mum her meal, which is contrary to what the diabetes nurse said.
It’s all quite worrying, and just one more thing to contend with.

 

[Saffie]

Having a husband who has been a diabetic for over 35 years, I don't think it's that dementia affects diabetes so much as that it makes the sufferer unable to recognise the warning signs of an impending hypo. and also to keep control of their glucose levels. My husband certainly had a number of hypos or near hypos in recent years, prior to diagnosis, whereas he had none before.

Were your mother's full hypos because I had to call the ambulance out for my husband on a few occasions as he was out cold. Other times, he was drowsy or fell and these times I poured sugar into warm water and was able to bring him back quite to consciousness quite quickly. Then, as instructed by the paramedics, I gave him a sandwich or some other high carbohydrate food to raise the level to normal.

My husband always controlled his diabetes himself as he was only 36 when diagnosed with it. Once I realised that he was not monitoring things properly himself, I took over the testing and monitoring of the glucose levels. He alsways injected himself though, right up until he went into hospital and thence to the nursing home.
Since he has been in the nursing home, he seems to be quite well monitored as he has had no further hypos and his diet is controlled by the nurses.

I couldn't comment on the district nurse giving the insulin as I don't know what the level was and don't know why your mother would need to be tested again before food but I do know it is important to have food within half an hour of being given insulin. So perhaps this has some bearing on it.

 

[Dunkers58]

hello , I agree with Safire that your mum cannot recognise the warning signs, do you think she needs a change in her dose if she is having so many. my friend used to say that if she did not eat enough her sugar dropped too low, so if your mum so appetite is not so good , could this be a reason.?

 

[Auntiep]

Thanks for your replies. Mum has been diabetic for most of my life (40+ years) and was also good at management prior to the dementia. Her insulin dose has been reduced, but her appetite is dwindling . Today she has eaten, but has since vomited. It's such a difficult balancing act.

P x

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[kkerr]

Is your Mum a Type I diabetic (became diabetic as a teen- always been dependent on insulin) or a Type II diabetic (became diabetic later in life, say after 30 years old?). It is very possible that with age, weight loss, decreased food intake, IF she is a Type II diabetic her insulin requirement may reduce considerably. Even for Type I's, if there food intake is drastically reduced or the content of their food changes, they may require less insulin. Overall, in older people - Hypos are FAR MORE DANGEROUS than a high blood sugar. I would ask your GP to make a diabetic referral, and have your Mom's need for insulin re-assessed. Personally, I would be testing her blood glucose BEFORE every insulin injection, and if it is < 5.0, I would be holding off insulin. Blood sugars can run up to 10-12 without any adverse effects. If she were younger, you would not want these levels for a long time, as they lead to increased risks of heart disease, diabetic foot and eye problems, etc, but in the short term, until you can get things reassessed I would err on the side of caution with insulin.

Has your Mum started any new medication recently - for her dementia or for anything else - as this can sometimes affect insulin needs.

Overall - get this checked out, get your GPs help or get a referral to a diabetes specialists. Hypos are dangerous, and as someone mentioned above, between the dementia and having had diabetes for a long time, her personal awareness of hypos may be significantly reduced, so she wont recognise the signs or take things to correct it. Hope that is helpful.

 

[kkerr]

Also worth looking at - from the hypo pattern you are describing, is your Mom on a mixed insuling, e.g. is a long acting + short acting type insulin like a Mixtard, Humulin, etc. If that is the case, then it could explain why she is having repeated hypos in one day - the long acting insulin dose is too high. Insulin adjustment is a bit of an art and best done by a specialist, but if she is on a mixed insulin, it may be that she either needs a lower overall dose or a different mix (less of the long acting component) or switching over to a short acting that is just taken before meals based on her current BM. That is probably too much information!!! Sorry!! See your GP and ask to see a diabetic specialist!

 

[60's child]

Hi Auntiep
My Mum has diabetes but is on tablets, not insulin. I think the only way it has been affected my dementia is she is no longer able to understand what she can eat and the importance of regular meal times. She lives next door and we are able to help her so not a problem. Does your Mum have a diabetic specialist nurse? If so maybe you could contact her for some advice? She probably has other patients who have dementia so may be able to offer some advice.