Has anyone had any experience with dealing with a parent with Type II Diabetes and Dementia where your parent regained their cognitive abilities fully? My mother seems to have very little control over her eating and drinking as well as her testing her blood sugar levels without my reminding her. Her doctor tells me that if she gains control over her blood sugar levels this is completely reversible. It just seems impossible to imagine since she has such a difficult time controlling her diabetes. Her doctor suggested counselling for her to look at why she may be eating and drinking too much. I am currently caring for her but she wants to go home. She lives in the country and about an hour and a half away from me so I am very hesitant to let her go home. At the very least, I will be looking for a live-in companion that can help if need be. Please let me know if you have experienced this and if you have seen it get better?????? Thank you!!!
Is this physician a general practitioner?... I have never heard of this and my Mom has a type II diabetic diagnosis. Her blood sugar is completely under control with medication and her Alzheimer's never improved one bit. Actually in all my years I have never heard of any dementia improvement due to controlling blood sugar.
The studies that connected blood sugar levels with dementia are actually new studies in the last few years. It just states that those with per-diabetes and type II diabetes are at a greater risk of developing vascular dementia and Alzheimer's. The diabetes does not cause the cognitive decline but whatever factors lead to the diabetes also contribute to the dementia. Fixing the diabetes does not make the dementia go away.
As for why your Mom eats and drinks the things she does... could it possibly be the dementia? Most with dementia have a sweet tooth and their impulse control is damaged by the dementia so they eat what they want with no awareness of the consequences. Uncontrolled type 2 diabetes will make your Mom extremely thirsty. She will want more to drink when her blood sugar is high. That is one way some know when the blood sugar is spiking. The combination of the two will lead to the sweet drinks as well as sweet treats. Talking to somebody as in counseling, with cognitive impairment, will do nothing to change the behavior. If they understand at all they will not remember or be able to follow the instructions.
So my experience is... do not expect cognitive impairment/dementia to improve.
Dear Janiesdaughter, As Deb said, reversible dementia from inadequately controlled T-2 diabetes sounds unusual. Do you mind giving us more information, especially relating to your mother's dementia history (e.g. how long, severity) and diabetic history? How high are her blood glucose running and for how long?
Usually, inadequately controlled T2's have high blood sugars (BG) leading to immediate symptoms of fatigue, headaches, increase thirst. Ultra high BG leads to ketoacidosis and electrolyte imbalance, which can lead to coma and then death. Temporary, reversible cognitive impairment is usually not a symptom. If there are some cognitive alterations, the symptom will go away immediately upon correction of BG. So reversal is rapid, much like recovering after drinking too much alcohol.
Long term inadequate BG control leads to sustained excessive BG, or hyperglycemia. This is the real health danger for T2's, and a lot of that damage from blood vessel and nerve damage like organ dysfunctions, atherosclerosis, neuropathies including and especially vision. Your brain also has essential blood vessels feeding it. Damage to these results in vascular dementia, or dementia because of blood vessel damage. Vascular dementia is generally irreversible, just like damage to vision and other organs from chronic hyperglycemia.
Counseling, as her doctor suggested, is predicated on the patient to be able to think rationally. In contrast, dementia is an "organic" condition, and the rationality is lost from the thinking process.
I understand and really sympathize with your concerns for your mother. However something about what you think her doctor said does not make sense. The real situation is always much more complicated than a few sentences can describe. Perhaps something is lost in the communication?
Last edited by Luau; 05-17-2012 at 03:55 AM.
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My mother has a (probable) undiagnosed dementia. She is also a diabetic who refuses to follow the diabetic diets, meaning she eats whatever she wants, whenever she wants...then insists the doctors 'need to do something to get her blood sugars under control'.
I went to her house the other day and the entire top of the kitchen table was covered with chocolate cake, a dozen boxed donuts, cupcakes, several packages of cookies, 2 pies...if it was left up to her, that is all she would eat...when she is lucid enough to eat. She MAKES my dad take her to the store and she buys this stuff when I'm not aware of it. My dad isn't a whole lot better off mentally than she is so he won't fight with her because she can become extremely mean.
When her sugar levels are too high (650 due to eating all the sweets she wants) or too low (46...due to NOT eating at all) her mental status declines drastically. I have the feeling this is probably what her doctor was referring to. IF/WHEN the sugar levels are maintained, the memory is improved. It doesn't necessarily mean the dementia is reversed is there is true dementia there. It only means the sugar levels can affect it.
My mother has a lot of memory/confusion issues, but when her sugars aren't where they should be, there is a significant decline which can be sudden.
I can tell you from personally experience that trying to fight an extremely strong-willed spouse is an exceedingly difficult, and thankless job. So in a lot of ways I sympathizes with your dad's plight. As long as your mom is mobile and can get to the grocery on her own, there is simply no way your dad can keep her away from her sweets. He can throw away the stuff she gets, but that won't stop her from simply buying more. People can say, simply get a backbone and refuse to drive her. That's an overly simplistic answer. It may work well for a caregiver who doesn't have to live with the person 24/7. As a daughter, for example, you simply take away the car keys. Then you get to go to your own home and not have to deal with her fuming and ranting. Or you retreat and seek solace and support from your spouse. But if you are the spouse and you are stuck with her, the whole game changes. Imagine that! How can he do that for the rest of their lives? AND... have to live with her 24/7! The best approach is a subtle one. You and Dad need to find an adequate substitute for her sweets. You simply can't take away her sweets without giving something to take its place. Try sugar-free candy and desserts. They do have those, made especially for diabetics and people with blood sugar problems. Then if she is cooperative, slowly wean her off those. With all those sweets lying around, I am guessing that your mom might also be dangerously overweight and at extreme risk for cardiovascular problems?
Ultimately your mother has bear the responsibility for her diet. If she is unable to comprehend fully the consequences, she will need to have a diet imposed upon her, which will be close to impossible outside a controlled environment of a care facility if she is combative or unwilling. With blood glucose running to 600 level routinely, neuropathy and organ failure is only a step away. She is at risk of loosing her eyesight, a leg, or suffering renal failure or cardiovascular failure within a couple of years. You need to have intervention to regain some blood sugar control STAT! I am not saying this lightly.
Last edited by Luau; 05-24-2012 at 05:01 AM.
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