Carer for an 84 year old

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slenderella

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Steroid Induced Diabetes
Hello

Thank you for letting me join - I just really want information and support.

I am the Carer of my much older 84 year old husband. I am somewhat concerned as back in December 2021 he was pre diabetic but we cut down on sugar in his coffee and the Surgery did not suggest any further treatment.

However he is now on steroids for his breathing issues plus steroids for his polymyalgia but in fairness GP trying to wean down and we have gone from 15mg to 12.5 but these are still high given his age. He has Ventolin and Fostair inhalers. He eats a HUGE amount of chocolate and biscuits and sugar which frankly is a real worry. I do know that there is something called 'steroid induced type 2 diabetes'. Please do not suggest I monitor his diet as he can be quite abusive. But I do try to keep things like cheese slices/chicken slices/beef slices crackers and bread in his fridge. We did have a dietician several years ago and she told me not to event ry to impose regular meals as he is very difficult - I am worried with regard to dementia so trying to do my best as a much younger wife of 33 years with no medical knowledge.

I guess all I can do is push for regular blood tests?
 
That does sound high risk of diabetes if he’s prediabetic and on steroids which raise bg and eating a lot of chocolates and biscuits etc. He should be having annual blood tests for the prediabetes, but if he has more regular blood tests for his other conditions then it would be worth seeing if the GP could do a hba1c at the same time.
 
Welcome @slenderella When you say you’re worried about dementia, do you think he might be showing signs of it? Sometimes it can show itself as irritability. Have you sought support and advice for this?

Yes, regular blood tests at the surgery would give you an idea of his blood glucose levels. It’s not just sugar, it’s all carbs, including savoury ones like bread and potatoes, that can raise blood glucose. It sounds like you’ve already made some subtle changes, eg having cold meat and cheese for hi to snack on. If you’re preparing his meals, you could also make some more subtle changes by slightly reducing the amount of carbohydrate he has and replacing it with extra green veg.
 
slenderella said:
Hello

Thank you for letting me join - I just really want information and support.

I am the Carer of my much older 84 year old husband. I am somewhat concerned as back in December 2021 he was pre diabetic but we cut down on sugar in his coffee and the Surgery did not suggest any further treatment.

However he is now on steroids for his breathing issues plus steroids for his polymyalgia but in fairness GP trying to wean down and we have gone from 15mg to 12.5 but these are still high given his age. He has Ventolin and Fostair inhalers. He eats a HUGE amount of chocolate and biscuits and sugar which frankly is a real worry. I do know that there is something called 'steroid induced type 2 diabetes'. Please do not suggest I monitor his diet as he can be quite abusive. But I do try to keep things like cheese slices/chicken slices/beef slices crackers and bread in his fridge. We did have a dietician several years ago and she told me not to event ry to impose regular meals as he is very difficult - I am worried with regard to dementia so trying to do my best as a much younger wife of 33 years with no medical knowledge.

I guess all I can do is push for regular blood tests?
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Crackers and bread will go stale faster in the fridge than at room temperature - but they are just as much carbohydrate as sugary things.
If you like baking there are low carb baked goods which are easy enough to make once you get the right ingredients - the 'sugarfreelondoner' site is good for recipes. Just make a dozen buns or biscuits and leave them in the kitchen or on the table where he'll see them.
If you cook swede or cauliflower instead of potato for mashing that will help as it is lower in carbs, also meals such as bacon and eggs - mushrooms and tomatoes as well perhaps, are low carb and they are a good choice as it reduces hunger to eat protein and fats. If your husband resists such meals, cook if for yourself and eat it in front of him - it will not only sustain you in adversity and daily life, but it smells really good. If he doesn't want the same thing before it is even on the plate I will be most surprised.
Chocolate with lower sugar, more cocoa is good - there is a brand with sweeteners instead of sugar if you can find it.
 
Inka said:
Welcome @slenderella When you say you’re worried about dementia, do you think he might be showing signs of it? Sometimes it can show itself as irritability. Have you sought support and advice for this?

Yes, regular blood tests at the surgery would give you an idea of his blood glucose levels. It’s not just sugar, it’s all carbs, including savoury ones like bread and potatoes, that can raise blood glucose. It sounds like you’ve already made some subtle changes, eg having cold meat and cheese for hi to snack on. If you’re preparing his meals, you could also make some more subtle changes by slightly reducing the amount of carbohydrate he has and replacing it with extra green veg.
Click to expand...
Yes the Memory Clinic app is on 15th. We had to cancel the last one due to him being in hospital. The scan apparently showed 'moderate atrophy of the frontal lobes' which suggests a diagnosis of frontotemporal dementia.
 
slenderella said:
Yes the Memory Clinic app is on 15th. We had to cancel the last one due to him being in hospital. The scan apparently showed 'moderate atrophy of the frontal lobes' which suggests a diagnosis of frontotemporal dementia.
Click to expand...
 
We have been married for 33 years but I do NOT prepare food for him although I do all the shopping - a lot done online as I do not drive. He has always been a very difficult man. For example when we got married in 1990 we would finish at the office at 530ish and he would then drink and play computer games sometimes wanting to cook/eat at 9.30 or sometimes falling asleep. So I have always sorted my own meals and left him to this own devices. Now I realise he needs more help. We did have a dietician and her advice was not to try and impose conventional meals on him as he can get very nasty and lash out. So all I can do is to keep 'easy' things in his fridge such as crackers, cheese and meat slices . We have had several GP appointments and I have been taking him to the Spar shop next door but I have been very shocked by the amount of sweet food he loads his basket with. No point challenging him. I am a little concerned about steroid induced diabetes so basically all I can do is to mention it to his GP - we are at different surgeries which does not help.
 
I am afraid I am a veggie and when we retired I tried to get husband to eat with me and when he had the heamatoma I tried again. Basically whilst I will try to do my best, he is very very difficult and a total bully, so I am very limited to how much monitoring I can realistically do. I have read that dementia can affect the taste buds and this does seem to fit in with the excessive amount of sugar he seems to eat. Frankly I have been a carer for 10 years of an increasingly difficult old man and this is just another thing for me to try and monitor.
 
@slenderella It sounds like he’s always been a similar way rather than the possible dementia affecting his personality. I hope you have sources of support and access to organisations that could support you if you wish.

Yes, dementia can change the sense of taste and could mean eating more sugar, or food preferences changing.
 
Sorry to hear about the difficult position you are in @slenderella :(

Do you get any help and support with your role as a carer? One of our mods @Docb may be able to offer some hints and advice about accessing carer support near you?

You must be very worried about your husband. His steroid treatment, while important and necessary, is already likely to be putting upward-pressure on his glucose levels, so it’s more important that ever for him to control his sweet tooth.

Of course, while you can be supportive, this isn’t something you can control - he really needs to make those choices for himself. It isn’t your responsibility, though it’s lovely of you to want to help!

I’m not sure if you know the result of his most recent HbA1c, but perhaps if he sees a formal diabetes diagnosis looming (or is told he has crossed the dividing line) it will change his perspective?
 
Hi @slenderella. I volunteer for a carers support charity, being a carer myself for somebody without diabetes.

As a carer, and no doubt you are, you might investigate what carer support services are available in your area. You start by searching for "carer services" and "your county council" in google. You should get a phone number for self referral. It may be to a council department or to the organisation that provides carer services for them. Ring them, explain your circumstances and take it from there. As a minimum you should be offered a carers assessment with the chance to talk about things to somebody who knows their way around the support available in your area.

I always add the caveat that carer services are a county council responsibility and the quality of the service varies widely across the country but if you live in one of the better areas you might find the support you need and deserve.
 
I think it is important to find out what his HbA1C is as you mention he was told he was prediabetic which would normally be 42- 47 mmol/mol and diabetic anything over that, but there seems to be some NICE guidelines to suggest that those levels are too low for the elderly, frail and those with co-morbidities. It may not be necessary to make much if any change so would be worth discussing with his GP.

Tackling the overtreatment of type 2 diabetes in frail older people through individualising care in East Sussex: a pharmacist led project

www.nice.org.uk www.nice.org.uk
 
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