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Old 05-15-2012, 05:49 AM   #1
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Dementia AND Type 1 diabetes?

Is there someone with experience caring for someone with advancing dementia compounded with Type 1 diabetes?

I am sure that most, if not all of you knows that Type 1 is insulin-dependent, where the afflicted individual needs to carefully manage their blood glucose throughout the day by carefully controlled diet, checking blood glucose levels, and administering the precise dose of insulin. These self checking and insulin happens 6 or more times each and every day, and slight errors can lead to hypoglycemic comas and death. Let the glucose run too hight, and one risks complications from cardiovascular diseases, neuropathy, and other issues commonly associated with diabetes.

In individuals with advancing dementia who are also afflicted with Type 1, there will come a time when the ability of the person to self-manage the diabetes become suspect. How do we get through the hump? What are your experiences?

 
Old 05-15-2012, 09:27 AM   #2
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Re: Dementia AND Type 1 diabetes?

This is an issue. Mom is borderline type two so I have not had the issues you will face. But there were several in Mom's facility that do have this problem. The answer is... Lucy is not going to be able to self monitor. There will need to be somebody with her that can do it for her. Her impulse control (as you have already seen) is diminished and she will not resist the things she can't have or eat the things she should. She will forget to self monitor her insulin level. The combination is detrimental to her health. This combination may land her in a facility quicker than those without the Type I diabetes. This is not from person experience but from professional experience (having worked in a care facility) and from observation. Behavior is the number one reason for care facility admissions... and complicating health issues that need monitoring (like Type I diabetes) is the number two reason.....

Love, deb

 
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Old 05-16-2012, 03:54 AM   #3
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Re: Dementia AND Type 1 diabetes?

I am really concerned, and I don't know how we will make it. I am already worn out, but I haven't really started yet.

From all that I have read, here and elsewhere, my wife's presentation is much closer to FTD/Picks than to early onset Alz. Personality changes, angers, retreat into seclusion, and her out of control obsession with dogs are the primary and initial drivers; questionable money handling surfaced a little later; glaring memory issues surfaced only recently. A stranger can talk to her and come away without the slightest idea that something is wrong. On the surface, she comes across as fully functional, albeit slightly batty dog lady. Put diabetes management and her penchant to have severe hypoglycemic episodes into the mix, and you have a disaster in the making. I am really worried. If my fears are realized, she will need to be placed in a care facility sooner than later. But, with her current belligerent and independent nature, care facilities will have their hands full, like I am having my hands more than full just trying to stem the mayhem almost daily. As others have mentioned, it is the unpredictabie and vicious anger episodes that are the hardest to handle. Even a simple request to ask her to repeat what she just said can elicit a 5 minute rant on how I am deaf, need my hearing checked, getting old, ... ... ... WW-3 happens on a simple hint that perhaps it is not a great idea, being a Type 1 diabetic, to eat 2/3's of son's birthday cake by herself. Yeah, it was purposely a small cake, but son and I wanted some too! She has no other family besides her two sons, one on either coast thousands of miles away. They are only in their 20ies and just starting their own lives. I cannot ask them to derail their future at such critical times in their lives. She almost estranged herself from one son last year. She went up to visit him, and 2 days later came home claiming son was being rude. Son was so angry at something that Mom did that he still hasn't told us what it was about except that his Mom was dissing him in front of his fiancee and close friends. She estranged herself from her only sister 8 years ago, and her favorite and only living aunt 3 years ago. (I am still trying to find ways to get Lucy to allow Aunt back into her life). I am the only person available to look out for her. There is no other family support. And let me tell you, she worked hard to estrange me too. I have just been too stupid to get estranged. I just don't know how I can do this. I work, I pay all the bills, I do all grocery shopping, most of the cooking, care and guide my teenage son, and lately trying to stem the financial disaster she continues to create. And thank god my housekeeper did not quit. Not yet, anyways. Did I already say I need to work? I have a demanding career which I am unwilling to give up. My career is what keeps me semi-sane these days.

Okay.. venting mode OFF. Hell of a way to start a morning by finding a hypoglycemic wife at 3am and spending the next two hours nursing her uncooperative self back into the safe zone. Another day trying to function on 4 hours of sleep.

Last edited by Luau; 05-16-2012 at 04:08 AM.

 
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Old 05-16-2012, 07:37 AM   #4
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Re: Dementia AND Type 1 diabetes?

I get it Luau and you are right that you can not continue doing this all by yourself. That is why you need that doctor's appointment sooner rather than later. Use the diabetic episodes to get her to the doctor and spill all that is going on as an explanation for the diabetic episodes which may help get the ball rolling.

Yes, with the Type I Diabetes, she is going to need round the clock monitoring and care quicker than someone without that complication. Even now, you can't depend on her to self monitor. No, she is not going to cooperate because she doesn't understand any more. She will seem to make it as difficult as possible... but remember it's not her choice to be this way.

Alienation of others is classic. Her lack of cognition will allow her to say and do things that are appalling. We react to her as if she is a fully cognitive adult and should know better. That set her off even more and the situation spirals up to a level we think of as hateful and hurtful. Then she cuts out what hurts. By isolating herself then she doesn't have to deal with all those people and it does make her life easier. She just sits in her room with her computer and dogs eating cake... if you would all just leave her alone and let her be.

Oh, and I learned never to ask mom to repeat herself because she couldn't. She didn't remember what she had said just moments before so she would lash out at me for being deaf or not paying attention. Her ideas are what she wants to do and how dare you stand between her and delight. Along with the diagnosis you can work on medication that will help control the emotional turmoil that she is feeling. What you are witnessing is her emotional turmoil created by the disease and what it has done. These behaviors can be lessened with proper treatment which will make her life, and yours better. But it will not solve the problem of the dementia. It will just make her a easier to manage.

Hang in there and get the diagnosis as soon as possible... for you own sanity!! Yes we do go back to that diagnosis word because you are stuck there until that is done. Until then keep venting and asking questions. It is what will keep you together for now

Love, deb

 
Old 05-16-2012, 05:59 PM   #5
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Re: Dementia AND Type 1 diabetes?

I too am faced with a similar situation with my mother. She is 68 years old with Type 2 Diabetes and Dementia. I don't know if it is ever going to get better. Her doctor says the dementia is completely reversible if her blood sugar levels are good for awhile. After 4 months I still don't see any light at the end of the tunnel.

 
Old 05-16-2012, 08:15 PM   #6
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Re: Dementia AND Type 1 diabetes?

Janie... I may be all wrong but they have just begun to learn about the possible link between type 2 diabetes and dementia. Type II diabetes is considered a risk factor just like many other heath issues but I have seen nothing that says if blood sugar is under control that cognition will return. You might want to check so there is not false home that it will go away...

Love, deb

 
Old 05-17-2012, 09:39 AM   #7
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Re: Dementia AND Type 1 diabetes?

As a follow up to what Deb have said, it is true that a possible link between dementia and diabetes has only recently come to light. Blood vessel and nerve damage by sustained excessive blood glucose is the leading cause of diabetic complications. So it makes sense, at least to me anyways, that damage to the blood vessels in the brain will hamper in oxygen and nutrient delivery to the brain. There is also some very early data from rat models that severe blood glucose depletion may also be deleterious to the brain, and this possibly occurs when the nutrient (e.g. glucose) starved brain is suddenly re-flooded with glucose. When this happens, the shock of the reperfusion may start a cascade of unwanted self-destructive processes. Again, this data is very preliminary. Nevertheless, there is no data of which I am aware, that says such damage is easily reversible.

Janie, I have given what you said a lot of thought. I am wondering if what your mom's doctor actually meant was that it is very important to control your mom's blood sugar, so that her body (including her brain) does not sustain any more unnecessary damage from her diabetic condition, and exacerbate her dementia.

 
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