High Blood Sugar: Unusual Behaviors and Their Impact on Family

High blood sugar can lead to some unusual behaviors?

Hello Dr.
Lin: My father is a diabetic patient (blind in both eyes) and has recently been exhibiting repetitive speech and sometimes forgets our family members' names.
Since my father cannot see, he used to know the locations of items in our home, but now he has forgotten everything.
When we took him to the hospital for a check-up, we discovered that his blood sugar levels were too high, and the doctor also mentioned kidney issues.
He is currently receiving insulin injections, but my father keeps trying to familiarize himself with the home environment and repeatedly asks the same questions.
I really don't know what to do.
Could you please give me some advice or recommend another hospital for consultation? Thank you.

Julia, 20~29 year old female. Ask Date: 2008/07/20

Dr. Lin Zijing reply Neurology

High blood sugar levels can sometimes lead to metabolic encephalopathy, resulting in delirium.
Once blood sugar is controlled, delirium typically improves.
However, if your father's blood sugar is well-controlled but he still frequently experiences episodes of confusion or memory issues, it may indicate dementia.
The underlying causes could be aging or small vessel disease due to diabetes, leading to multiple small vessel occlusions in the brain (multi-infarct dementia).
It is advisable to consult a neurologist for further evaluation.

Reply Date: 2008/07/20

More Info

High blood sugar, or hyperglycemia, can have profound effects on the body, particularly for individuals with diabetes. In your father's case, his symptoms of repetitive speech and memory issues may be linked to his elevated blood sugar levels. This condition can lead to a range of complications, including cognitive impairment, which is sometimes referred to as "diabetes-related cognitive dysfunction."
When blood sugar levels are consistently high, it can lead to a state known as hyperglycemic hyperosmolar state (HHS), which is characterized by severe dehydration and changes in consciousness. This is particularly concerning for individuals with diabetes, as it can exacerbate existing complications, such as kidney damage, which your father is also experiencing. The kidneys play a crucial role in filtering blood and regulating blood sugar levels, and when they are compromised, it can lead to further complications.

The symptoms you describe—repetitive questioning and confusion—can be indicative of a condition known as "diabetes-related cognitive dysfunction." This can occur due to prolonged periods of hyperglycemia, which may affect brain function. Additionally, the stress of managing a chronic illness like diabetes can also contribute to cognitive changes. It's essential to address these symptoms promptly, as they can significantly impact your father's quality of life and his ability to interact with family members.

In terms of treatment, it is crucial for your father to maintain stable blood sugar levels. This typically involves a combination of insulin therapy, dietary management, and regular monitoring of blood glucose levels. Since he is already on insulin, it may be beneficial to consult with his healthcare provider to ensure that his insulin regimen is appropriate for his current needs. Adjustments may be necessary if his blood sugar levels remain consistently high or if he experiences episodes of hypoglycemia (low blood sugar), which can also lead to confusion and cognitive issues.

In addition to medication, lifestyle modifications can play a significant role in managing diabetes. Encouraging a balanced diet that is low in simple sugars and high in fiber can help stabilize blood sugar levels. Regular physical activity is also important, as it can improve insulin sensitivity and overall health. However, given your father's condition, it is essential to consult with his healthcare provider before making any significant changes to his exercise routine.

If your father's symptoms persist or worsen, it may be advisable to seek a second opinion or consult a specialist, such as an endocrinologist or a geriatrician, who can provide a more comprehensive evaluation of his cognitive function and diabetes management. Additionally, consider involving a diabetes educator or a dietitian who can offer tailored advice on managing his condition effectively.

In summary, high blood sugar can lead to significant cognitive and physical health issues, particularly in individuals with diabetes. It is essential to maintain regular communication with healthcare providers to ensure that your father's treatment plan is effective and to address any emerging symptoms promptly. With appropriate management and support, it is possible to improve his quality of life and cognitive function.

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