Would like input for my 83 year old mom

[Joey_M]

Hi all,

My mom is 83 years old and has elevated glucose levels for about 5 years now. They rarely went over 150 and she has been able to control her glucose quite well through diet and exercise. But 2 months ago, she went into the hospital for 2 days for an unrelated issue & they fed her lots of high glycemic foods. Her doctor in the hospital said he was concerned she may have low blood sugar so my brothers fed her junk food and cake. When she got home, her glucose reading was 240 and that freaked her out. She returned to a good diet and her number dropped below 180. She went to her doctor for a routine visit and was very worried about her numbers so the doctor gave her xanax and glucophage. I got her to wait on both RX's and her numbers got down into the 130's - 140's with occasional 160's. She is good on her diet but slips a bit. She also walks over a mile 4 - 5 days a week. I just got her last lab results and her A1c was 6.5 & glucose was 128. I have a few questions:

1. Her glucose levels are always lower at the doc / hospital than home - could her testing equipment be bad? I changed the batteries a few times but doesn't seem to matter.

2. We prefer to keep her off glucophage as long as possible due to the possible side effects and not wanting another drug in her system at 83. What are people's thoughts on the benefit/need for meds at her current a1c level?

3. Her doctor shares very little info and when I went with her, he was angry when I asked questions. I found a better doctor but she is resistant to change although she doesn't like him - any ideas on how to persuade her?

4. How do I help her stay stricter on her diet - her weakness is white bread & noodles. I stocked her house with kamut pasta but when she makes food for my brothers, she uses white crap and then eats it herself.

5. My brothers think she should be left alone and I am too involved with helping her with her diet and that occasional sweets & white crap is ok - how do I educate them when they want to be in denial? It is hard doing it alone especially when they spend time with her and/or cook for her. BTW, I live in CA and she lives in IL - I fly there once a month for 4 or 5 days and stock her up on healthy foods and she does great when I am there. Work prevents me from more time with her.

Thanks,
Joey

[caregiver222]

You have a difficult situation and I sympathize.

There is no reason for you to "keep her off the glucophage as long as possible". It is apparent she needs this medication now. You are endangering her life by suggesting "she wait".

This medication has been along for a long time and the side effects are minimal.

[WaveRider]

First, congrats to your mother for understanding how to manage and control her diabetes and for you for being a caring son. Here's my 2 cents;

1. The FDA allows home glucose test meters a plus/minus accuracy range of 20%. The reading is an approximate range within 20% of the actual. A good FREE meter is the J&J Ultra One Touch Mini. Google 'free ultra one touch' for the web site. I would also question the doctors test equipment as to when it was last calibrated.

2. The A1c has been used for more than 25 years as the major measure of glucose control and to establish targets for diabetes therapy. Use this formula to convert A1C into average glucose [eAG = estimated Average Glucose].

eAG(mg/dl) = (28.7 x A1c) – 46.7
Your mother's eAGis [28.7 x 6.5 = 186.55 - 46.7] = 139.85 mg/dl

"She is good on her diet but slips a bit." She either has to manage this better or take the Metformin [Glucophage] to help lower her levels. I take 500 mg [1 tablet] of Metformin w/food once daily with zero side effects.

Xanax is RX'd for panic attacks and anxiety disorders. Strange drug to RX an 83 yo.

3. Change, even for the better, is hard for a lot of people to accept. We don't know your mother so little advice can be given except keep trying. Let the new doctor know so he/she can make her next office visit a lot more comfortable and reassuring.

4. White bread and white pasta are both high in digestible carbs. High carbs will jack up her glucose levels. However, all is not lost. For white pasta, try the brand Dreamfields. Claims 65% lower glycemic index and only 5 digestible carbs. I can eat as much as I want w/o it affecting my glucose levels. And it has good flavor too. Also, whole wheat breads. I have local bakeries that supply my area markets. They look and taste like white bread, contain no sugar, and are very low in carbs. Both recommended for type 2 diabetics.

5. Try group counseling.

HTH