Diabetes II doubts (from my father, 84 years old)

Hello.

My father is 84 years old.He was diagnosed with type II diabetes ten, approximately.It has been insulin for three months, in addition to the pills.Until then I was not doing any type of diet and exercise very little.It has some overweight (fat at the waist).

Two and a half months ago he had a stroke that he is still recovering.Physically it is better: he recovered left arm and leg movement, although not quite in his face and has to take care when swallowing and sometimes he is not understood well when he speaks.

I ask my doubts here because my father never lets us go to the endocrine and for him "everything is fine" ... I will try to go with him the next visit (October) and also to that of the neurologist (end of September), but whileSo much, now that I am helping him (in what is left), and controlling the diet, there are things that I am not very clear:

1) A sugar control is done in the morning, then the insulin is put on and, on an empty stomach, it will walk (it is not that it walks a lot, it goes slowly and it will be about 300 meters. It is accompanied by my mother, 81years).Is it dangerous?Should he eat at least one piece of fruit before leaving?
2) The glucose of after eating is not measured for a long time.The one in the morning on an empty stomach is within the limits that the neurologist told him after the stroke (90-180), in 110, more or less.Should I insist that measure 2 hours after eating?
3) It is with a hypocaloric diet (of 1,500 cal.) And hyposodic (it has the high tension, in treatment).I do not know if the lack of energy and the dream (it sleeps 7-8 hours at night, and 2 of nap, sometimes, after the morning walk, 2 hours) are still normal sequelae of the stroke or if you are eating too little.

Thanks in advance to whom you can lend me a hand.And also forgive in advance if these issues were already discussed here, but I have taken a quick look at the questions and I see that many are about DB type I ...

Hugs,

Berna

Good morning Berna!I'm going to take a little cable to how little I can.

What insulins are the ones you use?

In principle that glucose is taken in the morning before breakfast, it is great if their values ​​are among the 90-180 on an empty stomach is fine, to go walk and only do it (300m) nothing happens, as long as his father does notHe gets up with 60 sugar or 70 .. Even so, nothing would happen, since on an empty stomach and without breakfast and without injecting insulin it is difficult to have hypoglycemia because the basal acts and takes you out of those figures.So taking a 300m walk is not a big effort and nothing happens, although the best thing would be to eat something, inject its units and go out to walk, although the truth is that that does not influence much.

The theme of glucose after eating, it is important, it is something to leave, sincerely, that you have good glucose when fasting and eating is fine, but it must know 2h after having eaten how it feels and that it has goneThe units that are injected, is important to get an idea of ​​how to correct what happens, and know if units are missing or not, in that diet that you say below :) insists a little, it is more important to puncture before andAfter meals, it helps you know what you have and correct the later whether everything goes well or not.

For the issue of the diet, it is fine that an older person carries a hypocaloric diet, and more if he suffers from tension and sugar, so it is better to control the two issues, although he should not take it to a rajatabla since if he needs to eat somethingBut, look at the units to upload them a little and thus have more energy and than good walks "care with hypoglycemia" to burn sugar.

You will see how in Brief it is recovered and everything returns to normal, encourage and that everyone is like you who helps people sugish leaving a hand.

Greetings.

Hi, PRZ, thank you very much for answering :).

What insulins are the ones you use?

Levemir, says that two "feathers" get in the morning, on an empty stomach.

Also take Novonorm with meals, but I don't know the amount now (I have to look at his medication sheet, but he is in Madrid and until tomorrow I have no access to her).

On an empty stomach and without breakfast and without injecting insulin it is difficult to have hypoglycemia because the basal acts and takes you out of those figures.

The problem is that the first thing he does in the morning is to look at the glucose and prick the lighting.Then he is going to walk.The truth is that it is what he is doing here on the beach, because in Madrid he was without going out for more than a month and then began to do it to go to rehabilitation, and left breakfast.His routine there is to look at glucose, prick the Levemir, take some fruit and see the press online.Then take its 30 gr of whole wheat bread or fresh cheese (without salt) and a coffee decaffeinated with skim milk.

Although there are 300 m who will walk (stopping halfway for a long time, he is still weak), he gets tired a lot.In fact, in addition to the 8 hours of night sleep, a couple of days ago a head of between one and two hours after breakfast is thrown.And then a nap of another two hours after eating.And I worry a little.

The theme of glucose after eating, it is important, it is something that must not be left sincerely, that you have good glucose when fasting and eating is fine, but it must know 2h after having eaten how it feels and how suchThe units that are injected has gone, it is important to get an idea of ​​how to correct what happens, and know if units are missing or not, in that diet that you say below what it carries :) insist a little, it is more importantClick before and after meals, it helps you to know what you have and correct the later whether everything goes well or not.

I have insisted today at eating and told me that he doesn't care and that if something happens, because he better not find out: in short, what has done the man, look the other wayWhen there are problems, so now imagine, with 84 years ... I have pissed off with him but I have not insisted much because he alters and that is not good either ...

For the issue of the diet, it is fine that an older person carries a hypocaloric diet, and more if he suffers from tension and sugar, so it is better to control the two themes, although he should not take it to Rajatabla since ifYou need to eat something else, look at the units to upload them a little and thus have more energy and that of good walks "care with hypoglycemia" to burn sugar.

As he told us that the endocrine had told him, if he uploaded his glucose, one more insulin pen had to take the next day.But I wasn't doing it.We discovered it when the stroke, which we looked at the figures on his computer, and had been with more than 200 (now I do not remember well if it was the one in the morning on an empty stomach or the two hours after eating).

I do not know if the endocrine or the nurse (who taught him to prick the insulin) sent him somewhere to give him more information/training;Of course, if they did, he did not pay attention to them, just as he has been saying all these years saying that avoiding sweets and eating five times a day was perfectly (and then we found the blade with the hypocaloric diet between their papers)... But right now the problem is no longer that, it does not want to find out, it is so overwhelmed (I imagine, because it does not talk about the subject either) that looks the other way to see if so ... and what I have told him very seriousAt eating is that things, even if you don't see them, if they will happen they will happen the same.And he said "then better if I don't know" :(Anyway, I have worried me, because what I am not going to do is bring the riots to be forced to do what it has to do (and I will not measure sugar because it is not left), so the only thing that the only thing that the only thing that the only thing thatI can do, it seems, it is to get the idea that any day we will call 112 so it is and that I cannot do much.What is not a pleasant perspective ...

Anyway, thank you very much again for answering and for the spirits.

Kisses,

Berna

1) A sugar control is done in the morning, then the insulin is put on and, on an empty stomach, it will walk (it is not that it walks a lot, it goes slowly and it will be about 300 meters. It is accompanied by my mother, 81years).Is it dangerous?Should he eat at least one piece of fruit before leaving?
2) The glucose of after eating is not measured for a long time.The one in the morning on an empty stomach is within the limits that the neurologist told him after the stroke (90-180), in 110, more or less.Should I insist that measure 2 hours after eating?
3) It is with a hypocaloric diet (of 1,500 cal.) And hyposodic (it has the high tension, in treatment).I do not know if the lack of energy and the dream (it sleeps 7-8 hours at night, and 2 of nap, sometimes, after the morning walk, 2 hours) are still normal sequelae of the stroke or if you are eating too little.

To question 1.
Better who goes breakfast, even if it's little: 1 piece of fruit, 2-3 cookies
With figures above 150 nothing will happen to him but if 1 day about 100 he can give him a substitute.
You can try to convince you to take the fruit halfway, which sometimes you feel more to stop for a while, sit and eat it quietly.

To question 2.
I do not think that blood glucose should be systematically measured 2 hours after eating, much less without using an ultra -granted insulin.
In its circumstances, 1-2 times per week for me it would be logical to see how glycemia leads to those hours.
You should use postpandrial glycemia measurement to detect hypoglycemia, because the novonorm she takes is an oral antidiabic with the ability to produce hypoglycemia.It would be recommended (rather mandatory) that in all the meals in which carbohydrates always ate it (bread, rice, pasta, fruit ...)

To question 3.
1500 calories is not a hypocaloric diet.
As the caloric needs are younger years and 1500 calories could be hypocaloric if your father had a high physical activity, which does not seem to be so.
A restrictive diet in an 84 -year -old patient is crazy and impossible.
Better modify small things and 1 in 1.
For example, if you like a potato tortilla sandwich, try to eat it in the form of a skewer (bar, go), with less bread or try to mix the potato with onion, peppers, etc ... thus reducesThe amount of potato.

If you have difficulty swallowing, be careful above all with liquids.

It seems to me that, so you tell, your father is not carrying diabetes badly.
In addition, surely you have a good part of this good control.
As is logical, the same cannot be demanded as a young person.
His motivation for taking care of himself is less and that makes it very difficult to change habits and routines, but if he meets basic minimums and has a good quality of life, perhaps we have to value him much more to see him happy and happy than a blood glucose of 120.
This does not mean that it should not be taken care of but that the criteria to do so must be flexible and adapted to it.

Regarding sleep hours, it is recommended that throughout the day there are 8-9 hours maximum, no matter if they are fragmented.
In any case, it seems to me a topic without more importance.

Thanks, Owash :)

I will try to convince him to take the fruit before lowering (or to carry some cookies in his pocket, if he puts big heads).

To measure postprandial blood glucose (that of words that I am learning lately: d) even once or twice a week it has become complicated;He doesn't like him, come on.I will tell my brother to insist (so that I see that they are not hobbies that have suddenly given me ...).The funny thing is that he did it before the stroke and now it is seen that he welcomes him with high figures and instead of reacting taking action, he reacts with that "I do not want to know."And the fact is that I understand him, I understand the fear he has (he had fatal with the stroke), and I even understand that he prefers not to know ...

The 1500 -calorie diet takes it well.At first he was afraid to go hungry, but says he even eats more than before.There are dishes that do not like much (and we are taking note not to put them on), but there are even vegetables, and the soups love, so there is always a plate of vegetable soup.And it turns out that the whole bread likes more than white!And it is not that it does not take CH, of course, but that they are measured, just like the amount of fats.What has fatal is the salt .. and not being able to eat rice every day :).They have also told me that the elderly lose their sense of taste and need more salt/sugar to perceive the salty and sweet;Whatever it is, that is what he complains most ...

Thanks again for your advice :).Hugs,

Berna