1. GeordieAg

    GeordieAg Registered User

    Nov 1, 2018
    10
    Two weeks ago I had to take the difficult decision and move Mum to a care home as her dementia needs now far outweighed what I am able to provide. She has been diabetic (very well controlled) for over 30 years and, for the last 5 years, due to her dementia, I have been managing her diet and blood sugar levels.

    During the last 5 years at home she has only had around 8 hypo's but, since moving in to care 2 weeks ago, has already had 4 quite severe ones (blood sugars down to below 2.4 on each). During the day her blood sugar readings are fine but, even though her bedtime reading is the same as when she was at home, she crashes in the early hours of the morning.

    Due to the move we have had to change GP and Diabetic Nursing Support and, after another close call this weekend, have asked for a full review of her insulin as soon as possible in the hope that a change in dose may help.

    Has anyone else experienced this? I can't work out what's going on and am worried that, fantastic as the night staff are at keeping an eye on her, these episodes are so unpredictable. We are all working together to try and fix this, the nursing staff are listening to/acting on my experience of the last 5 years, but we are all baffled.
     
  2. nae sporran

    nae sporran Volunteer Host

    Oct 29, 2014
    6,238
    Male
    Bristol
    That is a worrying tome for you, GeodieAg. My partner has diabetes and dementia too. The nurse slowly brought down her dose of glicazide and replaced it with Alogliptin to reduce the chances of a hypo. They did also say that slightly higher HBA1C levels were not a major concern as she is 85 and the effects would not be felt until she is older, though they are now worried about her kidneys.
    Sorry that is a bit of ramble, but is seems to a delicate balancing act and I hope your mum's GP and the nursing staff can find a solution for you and for her.
     
  3. TNJJ

    TNJJ Registered User

    May 7, 2019
    978
    Female
    cornwall
    Has she got any hidden sweets etc hidden in her room?? I know a lot of PWD that are mobile tend to pick up things and squirrel them away in their room.
     
  4. MaNaAk

    MaNaAk Registered User

    Jun 19, 2016
    1,526
    Essex
    This is exactly what our local hospital had to do with dad before he went into the home. His gliclazide had to be completely removed and replaced with algogliptin after another fall.

    Also Nae Sporran how is your partner? I hope she is okay.

    MaNaAk
     
  5. Bod

    Bod Registered User

    Aug 30, 2013
    1,206
    How different is her last meal before bed, compared to living with you?
    The most likely cause, could be a change in diet, both in meal times, and food type/quantity.

    Bod
     
  6. GeordieAg

    GeordieAg Registered User

    Nov 1, 2018
    10
    Thanks, Nae Sporan. With the medication she's on, I'm guessing your partner is type 2. It's good that she's on Alogliptin - I've heard really good things about it. Mum is type 1, in her mid 90's and already has reduced kidney function and macular degeneration. My Dad was also type 1 for over 50 years (doesn't bode well for me.....), but being so strict about his control meant that he was able to travel the world for his job without any issues. We've all supported each other and kept things well managed, which is why I'm struggling to find a reason for this sudden change and number of hypo's Mum's had over the last two weeks. Hope things go well for your partner, and for you.
     
  7. GeordieAg

    GeordieAg Registered User

    Nov 1, 2018
    10
    She's not got access to anything like that, and has never eaten sweets since the day my Dad was diagnosed, which was 1970. The emergency stash of glucose items are locked in the medical cabinet in her room, but only the senior staff have keys to that. As there are a few type 2 diabetics in the same home, all the staff are very careful about what food is left around. Mum loves biscuits (given half a chance that's all she would eat!!) but is only given plain rich tea - one in a morning and one in the afternoon, then two plain digestives at bedtime. This is exactly the same as the regime we had at home.
     
  8. GeordieAg

    GeordieAg Registered User

    Nov 1, 2018
    10
    That's what I'm hoping, Bod. Yoghurt, bananas and pasta have been introduced (which she always refused previously), but otherwise the timing and type of food is pretty much the same. The portion sizes are bigger, but her quantity of consumption hasn't really changed. It also doesn't seem to be following a dietary pattern as the cottage pie and veg night was the worst crash so far, and that was something she always ate a lot of before moving to the care home.
     
  9. nae sporran

    nae sporran Volunteer Host

    Oct 29, 2014
    6,238
    Male
    Bristol
    She is ok, thanks MaNaAk. It's just another worry to keep us on our toes. Sorry @GeordieAg, hope your mum had a better night last night.
     
  10. MaNaAk

    MaNaAk Registered User

    Jun 19, 2016
    1,526
    Essex
    I know Nae Sporran even when dad was in the care home there was a time when I was afraid to look at my emails as dad started to become aggressive with the carers. However in they were a brilliant home and they managed his conditions very well and @GeordieAg I hope you had a better night as well.

    MaNaAk
     
  11. GeordieAg

    GeordieAg Registered User

    Nov 1, 2018
    10
    Well, after a couple of slightly better nights, I've insisted on an immediate and full review. Yesterday we had a very large and carb heavy lunch resulting in a reading of 17.0 at the 16:30 check. Too high for normal but after that lunch it was expected. District Nurse administered the prescribed dose of insulin and evening meal was eaten. At 21:00 a further check was done, which came back as 6.3 so more carbs needed before bed could even be considered. There is no pattern, just more and more questions :(
     
  12. Karen22

    Karen22 Registered User

    Nov 3, 2012
    80
    My dad had type 1 diabetes for over 60 years well controlled and he travelled widely and worked full-time. He got vascular dementia in 2015/6 and ended up in a nursing home where we had loads of problems with his blood sugars and he was in and out of hospital over two and a half years. It's so difficult when the person with diabetes can no longer understand their condition and keep themselves as well as possible. Could it be your mum is more stressed in the Home and that is causing her blood sugar levels to drop in the evening? Just a thought. You have my sympathies especially as you have had to change doctors and diabetic teams. Good luck with getting to the bottom of things.
    Karen
     
  13. GeordieAg

    GeordieAg Registered User

    Nov 1, 2018
    10
    Hi everyone. Well it's been a very emotional couple of weeks. After a night of multiple hypo's I totally lost the plot with everyone, Mum ended up in hospital and is now back to her usual self again.

    Two weeks ago her insulin injections were set at 28 units morning and 21 units evening, as they had been for many months. She is now been reviewed three times and re-set at 25 units morning and 12 units evening! Still don't have the answers as to why everything was so unpredictable, but at least we don't have the nightly hypo's to deal with now!
     
  14. Cat27

    Cat27 Volunteer Moderator

    Feb 27, 2015
    10,582
    Merseyside
    I’m glad you’ve things have stabilised @GeordieAg. I wish you a peaceful Christmas.
     

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