Medical opinion wanted

[cronewitch]

I know you aren't doctors but I just want opinion.

Mom is 86 and got diabetes Friday. Her blood sugar is over 300 and she is taking 1/2 of a Metformin twice a day. Saturday her blood sugar was down to 291.

Mom has been living on candy for her entire life and usually eats about 5 large fruits a day and some dinner rolls, maybe a salad.

So she should go on a good diet with real food. She will be seeing a dietitian and taking a diabetes education class but mom doesn't know much about nutrition and seems to want us to tell her what to do.

My brother and I are diabetic so have taken the classes and she lives with my brother.

I did talk her into telling me what meat and veggies she was willing to eat. I know she needs to knock off the candy and fruit diet. She only likes large fruit so I told her to offer to split them with my brother if they will brown before she should have more fruit.

She has felt really bad since October but after one day on drugs is feeling better so I think we should push her to eat better and take drugs. I know her blood sugar needs to go way down to under 100 fasting and under 140 two hours after meals.

She could stand losing 30lbs.

So the question is how serious is her diet needs considering her age if she can control the blood sugar with drugs?

[Deleted]

I think controlling it with food is generally preferable to drugs. Not to mention that not spiking her sugar with sweets, etc. will make it easier for the meds to work if she needs them.

My non-doc opinion.

[justme]

I'm not so sure metformin will control it (at least alone). My endocrinologist put me on it because I've had weight gain (and can't lose it even though my calorie count is low) and ever so slightly elevated blood sugar (103 at the highest) so she's wondering if I may have PCOS. So far it hasn't really lowered my blood sugar (first test was in the 90s, next was back at 101). Not sure whether that means she's wrong or the meds don't work for me or something else. But given my experience I wouldn't put stock in the drugs lowering it enough on its own. Also still a kid compared to your mom so I dunno if that means anything different.

[Iggy aka IG]

Crone, I started a low carb lifestyle last January, lost 35 pounds, and feel 110% better. I didn't have any blood sugar issues, but my great grandma did. I also prefer eating healthy over drugs when it comes to resolving health issues.

Ways to be successful when it comes to changing eating habits: Keep off-plan foods out of the house, keep on plan foods prepared (washed and cut up, etc.), plan meals, do research, and find a support system.

[cronewitch]

Dec 9, 2012 23:02:09 GMT -5 Iggy aka IG said:

Crone, I started a low carb lifestyle last January, lost 35 pounds, and feel 110% better. I didn't have any blood sugar issues, but my great grandma did. I also prefer eating healthy over drugs when it comes to resolving health issues.

Ways to be successful when it comes to changing eating habits: Keep off-plan foods out of the house, keep on plan foods prepared (washed and cut up, etc.), plan meals, do research, and find a support system.

She is lucky to live in my brother's house, they do all the cooking and food shopping. DB is on a diabetic diet and his wife on WW usually. They will not cook unhealthy food so if mom just ate what they ate she would be fine. Mom doesn't like chicken breast and won't eat rice so usually just snacks on fruit and candy seldom eating hot food.

I controlled my blood sugar and blood pressure with diet but I eat soup, mom won't eat soup. SIL makes good home made soup.

Mom was told she has high blood pressure as well and diabetes so should eat healthy but not sure she will. SIL said she is done raising 2 year olds so really doesn't want to be mom's food police.

I take mom shopping and usually she buys lots of candy but Saturday she didn't. I might be embarrassing to her if she tries to buy candy when I am with her.

[Iggy aka IG]

Crone, good for you for correcting your health naturally. . As far as your mom, it's a good thing, IMHO, she doesn't eat rice. Assuming it's white rice, it's a high-glycemic food, as is most fruit. About the candy issue: I can understand where your SIL is coming from. Ultimately it's up to your mom if she prefers the meds over food choices.

[Sammy]

Well, at the age of 86 with a history of poor eating habits I can't see the doctors having much success with keeping her healthier. What I would be concerned about is the end result of diabetes meaning damage to organs and circulation and the resulting surgeries. She is eating a great deal of sugar in the fruit and candy. I'm bowled over reading how much candy she eats. If the food is not in the house she will not have access to it. Of course I'm sure there Mom will make everyone miserable.

Crone, you already have been educated about a healthy diabetic diet so you know what needs to be done. Good luck with Mom.

[weltschmerz]

She's 86? How much pleasure is she getting out of her life apart from the fruit and candy she loves? There's plenty of diabetic candy out there that tastes pretty good. Have you tried that? To be perfectly honest, I personally wouldn't try to change her life completely around at this point....she's been like this for 86 years. Some minor changes, like cutting down, but not completely cutting out the things she loves, would be preferable at this point.

This is my own personal opinion, of course. I would treat a 50 yr old much differently than an 86 yr old. We have an 85 yr old gentleman in the hospital who loves his smokes. Some of the staff and docs come down hard on him to stop. I say leave him alone. He's an old man with few pleasures left. His advanced age will probably do him in before the cigarettes do.

Mom is 86 and got diabetes Friday. Her blood sugar is over 300 and she is taking 1/2 of a Metformin twice a day. Saturday her blood sugar was down to 291.

She didn't get diabetes on Friday. She's probably had it for quite some time.

[Sammy]

I have to agree with you, Weltz. However, Diabetes can cause a lot of serious health issues and at the age of 86 wouldn't it be better to live the rest of your life in comfort by making some minor changes in your diet than to suddenly be facing some the tougher effects of the disease??

[reader79]

I was diagnosed in August, my blood sugar was 351, they eased me onto 1000mg of metformin 2x a day, simvastatin, and baby aspirin. I am also supposed to be taking insulin, but it got ruined in the storm. I have an appt on the 28th, and my levels are getting back to 'regular' without it, so I am going to ask if I can skip a refill for now. I don't want to inject myself for the next 50 years if I can't help it.

My goals are under 130 fasting, and 180 two hours post-meal. I am supposed to eat lots of leafy green vegetables, nuts, etc., and lay off the carbs. They told me absolutely no juice and no regular soda. It has been a rough adjustment, as my previous diet was pasta, potatoes and Pepsi. Sigh.... flavored seltzer is just not cutting it. I am also supposed to try to exercise an hour a day, up to five times a week.

At my age, 33, I would say that the need for drastic changes are mandatory. If I don't keep this under control I will start to have vision problems, issues with circulation, etc. I am looking at a downward spiral with a fair amount of my life still left. If I was in my 80's I would probably feel differently about changing so much. I think it depends on how she feels now while medicated, and if she can follow the dietary demands without too much effort. Frankly, that was the hardest for me.

If your brother is already following the diet, and your mother does not have to cook, it is going to be about changing her snack foods and reducing the candy intake. Does she exercise - does she want to? Maybe she could get a treadmill and walk while she watches tv or something.

No one wants to deny an 86-year-old their little pleasures though. I wish you luck, and your mother good health.

[weltschmerz]

Crone, is she lucid and alert? What does SHE want? Perhaps you could point out the pros and cons of following a stricter diabetic diet, emphasizing the possible deleterious effects on her health. I myself, am a fruit junkie. I LOVE fruit. I've been known to go out in the middle of the night in a snow storm because I was jonesing for fruit. If I was 86 and someone told me I would have to give up my fruit because in time, I might lose my vision or my limbs, I would tell them to piss off.

[cronewitch]

Mom is using a rolling walker now and shopping is her exercise plan. She can walk a super Walmart but needs to sit to get things out of her purse and then after one store is too tired to go to other stores.

I think I can get her to stick to a reasonable diet since she was feeling horrid since October and asked me if I thought she was dying. The doctors couldn't help her and I think she was really scared so now they found something to treat. She was starting to count the calories in her candy in an attempt to lose weight. Two years ago she lost 46lbs and was walking a few blocks to town and shopping, picking up things in the yard and tending flowers. She said this was her last year to pick up the yard and she won't have flowers anymore. Then just the last two months fell once, got scared and got the walker and was hurting all the time, kept going to doctors that didn't do anything. She had my brother take her to urgent care Friday where they ran test and found high blood pressure and high blood sugar.

Her problem with the diet is she thinks she can't understand or remember things but she can. She forgets words sometimes and has some brain fog playing cards but she can read labels and knows what foods are healthy. She has had to buy bigger clothing the last few months so wants to lose some weight. She just wants to be babied and then complain about the food.

My brother will take her to her diabetes education classes but I think he will expect her to think for herself, not make him choose her food. He and his wife are taking a vacation after Christmas so if her class is then he can't take her. Her granddaughter told her she works from home and has a flexible schedule and would be happy to take her, mom has no excuses to not go or not pay attention in class.

[Formerly SK]

Dec 10, 2012 0:40:49 GMT -5 weltschmerz said:

Crone, is she lucid and alert? What does SHE want? Perhaps you could point out the pros and cons of following a stricter diabetic diet, emphasizing the possible deleterious effects on her health. I myself, am a fruit junkie. I LOVE fruit. I've been known to go out in the middle of the night in a snow storm because I was jonesing for fruit. If I was 86 and someone told me I would have to give up my fruit because in time, I might lose my vision or my limbs, I would tell them to piss off.

I eat 2-3 honeycrisp apples a day. I don't think anything could make me give them up.

[weltschmerz]

Some fruits are much better for diabetics than others. Blueberries, cherries, mangoes, pears and kiwis are lower in carbs than others. There's a wealth of information online.

www.everydayhealth.com/diabetes-pictures/best-fruits-for-diabetes.aspx#/slide-1
Try to avoid fruit JUICE.

[lurkyloo]

Welts' point about diabetic candy is a good one. Do you guys have a Harry & David's nearby, maybe an outlet? They have a pretty big line of sugar-free candy (and splurging on H&D prices might help your mom feel like she's getting her "naughty" fix in).

Are there fruits that are lower in sugar; bananas maybe? Or start to swap in some veggies for the fruit? Agree that your standard 86-year-old isn't going to take well to major lifestyle changes; I'd try to focus on winnable battles for now and go ahead with medication too.

Good luck. It's frustrating as all hell trying to get someone to regularly do something they don't want to, for their own good, and worse when it's a parent.

[weltschmerz]

There's lots of sugar-free candy out there. It's not bad.

[Deleted]

Dec 10, 2012 0:40:49 GMT -5 weltschmerz said:

Crone, is she lucid and alert? What does SHE want? Perhaps you could point out the pros and cons of following a stricter diabetic diet, emphasizing the possible deleterious effects on her health. I myself, am a fruit junkie. I LOVE fruit. I've been known to go out in the middle of the night in a snow storm because I was jonesing for fruit. If I was 86 and someone told me I would have to give up my fruit because in time, I might lose my vision or my limbs, I would tell them to piss off.

I agree with Welts. She is 86. Is SHE motivated to make these changes? If so, great, most hospitals have Diabetes Educators where you can take classes, get nutrition help and so forth. And, she may need to be put on medication. But, honestly, at 86, she could make some changes but she should still enjoy what she enjoys.

[Bluerobin]

If she lives with DB, don't enable her by having junk in the house that she shouldn't eat. Diet controlled is definitely better than medication controlled. The problem is that too many people figure the medication will allow them to eat what they want. The fact is the meds just help, they don't cure. Therefore, you still have to watch what you eat.

[zibazinski]

My dad was diabetic. He used to take shots because he told me, he wanted to eat what he wanted to eat. When he told me that if he lost weight and watched what he ate, he wouldn't have to take shots, I was floored. I never did understand it.

[Colleenz]

FYI - the metformin has some negative feedback if she eats too much sugar. Nothing dangerous, but definitely unpleasant.

[muttleynfelix]

I would see how she responds to the diabetes education class. Hopefully, meeting with the dietician and learning about it will help her make the changes that she need.

My grandma had quite the sweet tooth until she was diagnosed at age 84 with Type II diabetes. She limitted her sweets and never did have to go on medication and the next time she went back to the doctor he considered her "cured". I currently have gestational diabetes. It honestly scared the crap out of me when I was diagnosed. Like what in the world am I going to eat. But other than giving up regular soda, I've found I can eat what I want, just not as much as I want or maybe when I want it. I gave up candy because I would prefer to eat ice cream and I gave up popcorn because I know I can't stay within the "right amount". Anyway, hopefully the dietician can get through to her about how much of her favorites she can eat and when to eat them. I don't know if the Type II course makes you do this, but having to practice giving myself a shot in case I had to go on insulin scared me enough to stick to my diet. I'm pretty squeemish and that about did me in. I also think it is easier having GD than Type II because I know when I have the baby I don't have to worry about it as much.

[mandyms]

Dec 10, 2012 0:51:46 GMT -5 Formerly SK said:

Dec 10, 2012 0:40:49 GMT -5 weltschmerz said:

Crone, is she lucid and alert? What does SHE want? Perhaps you could point out the pros and cons of following a stricter diabetic diet, emphasizing the possible deleterious effects on her health. I myself, am a fruit junkie. I LOVE fruit. I've been known to go out in the middle of the night in a snow storm because I was jonesing for fruit. If I was 86 and someone told me I would have to give up my fruit because in time, I might lose my vision or my limbs, I would tell them to piss off.

I eat 2-3 honeycrisp apples a day. I don't think anything could make me give them up.

I haven't read any responses, but I'll add my opinion; I'm a dietitian. Honestly, I get a lot of older adults with newly diagnosed diabetes. I don't go into strict carb control with this population; just try to limit candy if she's really over doing it (will she do sugar free?), fruit juice, reg soda.

Getting some light strength training may help w/blood sugars (as well as mobility/balance/immune system). Collage video has a great catalog (online available as well) with a section on "specialty" (i.e. limited mobility, older adults, handicap).

She's 86, having high blood sugars under 200 might be the goal depending on her doctor. Complication from diabetes (dialysis, etc) would probably be the last thing I would worry about right now as these usually take at least 10-15 years to start showing up in the worst cases.

ETA: if she WANTS to make some other significant changes, great for her! I do have some older patients wanting the info and making these changes. The above was said if she doesn't want to do the complete 180 turnaround on diet.

[swamp]

If I make it to 86, I'm going to eat, drink, and smoke whatever the hell I want.

[Iggy aka IG]

Dec 10, 2012 10:54:35 GMT -5 @sroo4 said:

If I make it to 86, I'm going to eat, drink, and smoke whatever the hell I want.

My boss had the best quote (which I've blatantly stolen)

"Once I turn 80 it's whiskey and roller coasters"

[Deleted]

Dec 10, 2012 10:46:24 GMT -5 swamp said:

If I make it to 86, I'm going to eat, drink, and smoke whatever the hell I want.

That is my opinion. I will do likewise.

[TheOtherMe]

Dec 10, 2012 10:46:24 GMT -5 swamp said:

If I make it to 86, I'm going to eat, drink, and smoke whatever the hell I want.

That is what my mother said about still smoking when she was 86. A near death bout of pneumonia caused her to actually stop smoking at age 86. We never, ever thought she'd quit smoking at that age.

[cronewitch]

Mom's great granddaughter told mom she would be dead in 2025. She was born in 1924 and her mom died just short of 99 so the girl thinks that must be how long people live. Her great grandson was asking if anyone lived to 100 and we decided mom should be the first. Most women live to 97 or 98 in our family so even if she doesn't make 100 even 10-15 more years would be hard to be in pain that long.

We kinda have her convinced to try filling 1/2 a plate of veggies, 1/4 carbs and 1/4 protein until she figures out what to do. She is a little confused about things like cottage cheese but I explained a 1/2 cup is 5 carbs and 520 sodium so she should only have half a cup at a time. The doctor was going to put her on blood pressure medicine but forgot to write the prescription so I told her to limit sodium to less than 1500 a day.

She likes some raw veggies just not cooked ones so a cucumber and cottage cheese is a nice little meal for her.

[milee]

cronewitch, if she wants to try but is just struggling with figuring it all out, can you help her put together a starter list of meals and snacks that are OK? Then she doesn't have to think so much at every meal, she can just choose from the list.

One of my sons just had a pretty major diet change and it's very overwhelming for the first few weeks. All of a sudden, eating is a stressful chore and it can feel like you'll never get to eat anything you enjoy or normally again. But if you start with making a list of what you can have, soon it starts to become more second nature and normal. After a while, it will get easier.

[kittensaver]

Dec 10, 2012 11:15:03 GMT -5 @shooby said:

Dec 10, 2012 10:46:24 GMT -5 swamp said:

If I make it to 86, I'm going to eat, drink, and smoke whatever the hell I want.

That is my opinion. I will do likewise.

Me too!

[Iggy aka IG]

Dec 10, 2012 13:42:49 GMT -5 cronewitch said:

We kinda have her convinced to try filling 1/2 a plate of veggies, 1/4 carbs and 1/4 protein until she figures out what to do. She is a little confused about things like cottage cheese but I explained a 1/2 cup is 5 carbs and 520 sodium so she should only have half a cup at a time. The doctor was going to put her on blood pressure medicine but forgot to write the prescription so I told her to limit sodium to less than 1500 a day.

She likes some raw veggies just not cooked ones so a cucumber and cottage cheese is a nice little meal for her.

This is a good point about the small meal, especially since she is a grazer. I have read it is better to consume smaller, mini meals throughout the day, rather than have 3 larger meals to avoid spikes in blood sugar. Some of my low carb favorites:

Sliced ham w/ a bit of cheese
Cheese and dill pickle
1/2 cup (portion control is SO important) cottage cheese w/ almonds (again, count them)
A low carb yogurt (Carbmaster @ Kroger for instance)
Romaine leaves w/ tuna or chicken salad
Asian lettuce roll ups (I make them with chicken but since your mom doesn't like chicken, a different protein can be substituted)
2 chopped boiled eggs w/ mustard and mayo

The list is endless. I can send a link if anyone is interested just PM me.