Managing Blood Sugar Levels: Insights for Seniors with Diabetes

High blood sugar issue?

My mother is 75 years old, weighs 70 kg, and her fasting blood sugar in the morning is 83 mg/dL, while it rises to 180 mg/dL after meals.
She has been experiencing increasingly blurred vision, and after dinner around 6 PM, she reported some numbness and discomfort in her head and shoulders after 8:30 PM, which resolved when she sat up straight.
I suggested checking her blood sugar again, and it was 278 mg/dL.
Since it was time for bed, she administered her usual dose of 10 units of insulin before resting.
This morning, her fasting blood sugar was 68 mg/dL.
Could this be due to not managing her dinner properly? She didn't eat much, and the rice was brown rice.
I reminded her to chew slowly and not eat too quickly.
Although it's not convenient to go out during the pandemic, she should still try to stay active after meals.

ZLin, 30~39 year old female. Ask Date: 2020/04/20

Dr. Lin Jianliang reply Internal Medicine

Based on your description, there are many reasons for poor blood sugar control, including diet, medication, exercise, and the functioning of the liver and kidneys, as well as other underlying conditions.
It is advisable to consult your mother's attending physician to seek solutions.

Reply Date: 2020/04/20

More Info

Managing blood sugar levels in seniors, especially those with diabetes, requires a comprehensive approach that includes monitoring blood glucose levels, understanding the effects of diet and exercise, and recognizing the signs of potential complications. Your mother's situation highlights several important aspects of diabetes management that are crucial for her health and well-being.

Firstly, it’s essential to understand the normal ranges for blood sugar levels. For most adults, fasting blood sugar levels should be between 70 and 100 mg/dL, while postprandial (after eating) levels should ideally be less than 180 mg/dL one to two hours after a meal. In your mother's case, her fasting blood sugar of 83 mg/dL is within the normal range, but her post-meal reading of 278 mg/dL is significantly elevated, indicating that her body is struggling to manage glucose after meals.

The symptoms your mother is experiencing, such as blurred vision and tingling sensations in her head and shoulders, could be related to fluctuations in her blood sugar levels. Blurred vision can occur when blood sugar levels are too high, as it can lead to swelling in the lenses of the eyes, affecting vision. The tingling sensation may be a sign of neuropathy, which is a common complication of diabetes, especially if blood sugar levels are not well controlled over time.

Regarding the evening meal, it’s important to consider not just the quantity of food consumed but also the types of carbohydrates and the overall balance of the meal. Even healthy options like brown rice can cause spikes in blood sugar if consumed in large amounts or without adequate protein and healthy fats to slow down absorption. Encouraging your mother to eat slowly and chew her food thoroughly is a good strategy, as it can help with digestion and may prevent overeating.

The significant drop in her fasting blood sugar to 68 mg/dL the following morning could be attributed to several factors, including the insulin she administered before bed. While insulin is crucial for managing diabetes, it’s important to ensure that the dosage is appropriate for her current blood sugar levels and dietary intake. A reading of 68 mg/dL is considered low (hypoglycemia), which can lead to symptoms such as dizziness, confusion, and weakness. It’s vital to monitor her blood sugar levels closely, especially after adjusting her diet or insulin dosage.

In addition to monitoring blood sugar levels, regular physical activity is beneficial for managing diabetes. Exercise helps improve insulin sensitivity and can aid in controlling blood sugar levels. Encouraging your mother to engage in light to moderate physical activity, such as walking or stretching, can be beneficial, especially after meals.

It’s also essential to maintain regular communication with her healthcare provider. They can help adjust her insulin regimen, provide dietary recommendations, and monitor for any potential complications related to diabetes. Regular check-ups and blood tests, including HbA1c levels, can provide insights into her long-term blood sugar control.

Lastly, consider the emotional and psychological aspects of living with diabetes. It can be overwhelming for seniors to manage their condition, and support from family members can make a significant difference. Encourage open discussions about her feelings and experiences with diabetes management, and consider involving a diabetes educator or nutritionist for additional support.

In summary, managing blood sugar levels in seniors with diabetes involves a combination of careful monitoring, dietary management, regular physical activity, and ongoing communication with healthcare providers. By addressing these factors, you can help your mother maintain better control over her diabetes and improve her overall quality of life.

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