Mother taken off insulin HBA 40

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Seabreeze

Seabreeze

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My 91 year old mother has been taken off insulin due to her recent HBA result being 40

She hasn't been eating much for a year or more, infant portions or less.
She's gone down 2 dress sizes and her blood sugar results were dropping down to 6's so her insulin was reduced and a few weeks later had the Hba blood test, the surgery nurse phoned and said said to half the insulin. I phoned the Dr a week later to say she was very unwell and sleepy, couldn't keep her awake for drinks even and she's been in bed all week. He told me she should not be on insulin with hba at that level. I now have no faith in the surgery nurse at all.

Keeping an eye on her blood sugar levels the next few weeks to see how she goes.
She's brighter but weak.
 
I'm so sorry about this. You must be very worried. However I'd be more concerned about what the doctor said than the surgery nurse. Blood sugars should be around 6 and a HBA1C of 40 is not particularly low. Diabetic weight loss is usually a result of blood sugars being too high so these results would not have caused her weight loss. Also it would have been the insulin that has made these levels what most diabetics would consider to be good. How are her levels now that her insulin has been stopped and have they done further investigations as to why she is losing weight and feeling so ill?
 
I can't offer advice on treatment, but wonder if something 'special' might tempt your mum - maybe some salmon or perhaps lamb with salad and a couple of new potatoes, a cream cake or chocolate éclair, a little wine or even cider - anything to give her a little lift in her spirits and nutrition.
 
AJLang said:
I'm so sorry about this. You must be very worried. However I'd be more concerned about what the doctor said than the surgery nurse. Blood sugars should be around 6 and a HBA1C of 40 is not particularly low. Diabetic weight loss is usually a result of blood sugars being too high so these results would not have caused her weight loss. Also it would have been the insulin that has made these levels what most diabetics would consider to be good. How are her levels now that her insulin has been stopped and have they done further investigations as to why she is losing weight and feeling so ill?
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Blood sugars of 6s aren’t particularly low for normal adults but at the older age of 91 they like to keep blood sugars a bit higher, because the risk of hypos is significantly more of a problem than the likelihood of long term complications.
 
I would be wondering if there was anything else going on, eg an infection. My elderly mum ended up with many UTIs. She went very sleepy and also, at times, a 'bit out of it'.
 
If your mum is on a fixed dose and she is not eating so much then her insulin does need to be lowered. Was she on a mixed insulin? If so perhaps just a long acting would be helpful.

I hope your mum is soon feeling better.
 
Glad to hear your Mum is feeling brighter, and thank goodness they lowered her insulin doses to better reflect her reduced appetite.

Hope your mum feels able to eat a little more soon.
 
Thanks everyone

I go with the Dr advice over the nurse.
They said that for her age and appetite her blood sugar range is 9 to 15
Below 8 is risk of her going hypo because she isn't eating enough

My mum has a very sedentary lifestyle, an ulcer, lung disease, heart disease, strokes.

As said the GP said her body is breaking down and not needing so much food.

She started antibiotics on Friday for an infection.
Her bloods are around 10 and 11 at the moment.

At her normal, she can be outfaced by food, I do a small plate and small portions.
A dessert spoon of veg x 2, one new potato and half a fish finger size of meat/fish.
On a good day she has half of that, mostly a quarter or less.

An open sandwich on one slice of bread she will manage half to 3/4 on a good day.
Sat she had a 1/4 of one with crab.

Lunch can be tuc crackers with whatever, she's normally having 2 now, gone down from 3, whereas before she would have 4 or more.

or raspberries, melon and cherries
sugar free jelly and mandarins and/or cream
Home made soup

She enjoys salad when she can manage some and seems to do better with that than a cooked meal.
 
My mother can't handle heavy food now, it is too much for her digestive system.
She is better with fish than meat now.
She can't manage spices.

I have to chop her food for her as her hands aren't good and she is nearly blind.

Yes her diet is limited
Yes she gets bored - I try to make changes and surprises and treats.
But the options are limited.

The best way to get meat into her is to almost flake the meat cold and give her it on crackers or one slice of bread.
Or make beef tea, she can't eat stewed or braised meat now, but she loves the beef tea.

I gave her a few thin slices of an eclair the other week when she wasn't eating and she managed those very well!

I am mixing raspberries into sugar free yoghurt for her or getting sugar free cherry yoghurt for her to have a few times a week.

two teaplate thin pancakes with lemon and sweetener as the odd treat for tea.
She used to have one savoury and two or three lemon ones.

Cheese scones to have with the soup - half the size from the shops
plain scone with crushed raspberries and sweetener and cream once a month
 
Elderly people sometimes don't have much appetite and not being able to see things doesn't help but you sound to be doing a brilliant job of making tempting meals for her.
Have you tried the high protein yoghurts or quark based deserts.
What about eggs as they are easy to eat.
My other half mother is 97 and had just had a fall and broken her hip so is in hospital but is virtually eating nothing and she sleeps pretty well all the time. She also can't see with macular degeneration and her hearing is practically non existent so really poor quality of life.
It is no fun getting old.
 
All her stats are good - temperature, blood oxygen, blood pressure.
She is well in herself.
But no appetite some days
hungry other days but not eat much
good appetite and eats half to 3/4 of her food on rare days

The GP said it is normal for her age.
As said her body is breaking down with age.
He advised that milk is good, gives her a lot of what she needs the nurse was opposing milk until I said the Dr told me to give her it. She is not a diabetic trained nurse, she is the practice nurse. I joined the patient forum group to point out how essential it is to have a nurse trained and specialising in diabetes. One can hope.

Yes, to those who said it could be something else, it has been on my mind, but I need to get her balanced out from the insulin removal for a few weeks or so.
UTIs are common here, they are great fun with the confusion!

Sleepiness - oh she's old, it's the strokes - I know my mum and this is inordinately sleepy, it is wrong!
The sleepiness is subsiding now and she is brighter but she has an infection - one step forward, two back!

She can be a pickle at times and a connundrum.

On another level, I can overthink it wondering about cancer.
My dad had pancreatic cancer at 93, he was older than my mum.
I can overthink and see similarities and wonder if I am not being told things because my mum is so frail she is inoperable and chemo would be too brutal for her. I have permission from my mum to discuss with her doctor and I have told the doctor not to hide things from me, I want to know.

On a side note, yes all the things are done, DNAR, end of life care, will, power of attorney, funeral plan paid so we can just enjoy ourselves now.
 
Leadinglights said:
Elderly people sometimes don't have much appetite and not being able to see things doesn't help but you sound to be doing a brilliant job of making tempting meals for her.
Have you tried the high protein yoghurts or quark based deserts.
What about eggs as they are easy to eat.
My other half mother is 97 and had just had a fall and broken her hip so is in hospital but is virtually eating nothing and she sleeps pretty well all the time. She also can't see with macular degeneration and her hearing is practically non existent so really poor quality of life.
It is no fun getting old.
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Thanks
I will look into those thanks.
My mum isn't struck on eggs, I try to do them once a week, boiled or poached or egg and chips once a month.

Bless her. Sleep is good for healing but so is food, I hope she can manage to eat a bit more soon.
Can she or will she drink milk?
The first few days in hospital when my mum is hospitalised she eats very little and I spoon feed her.
I was spoon feeding my mum at times last week.

My mother is blind in one eye - wet macular degeneration and has dry macular in the other eye with very little sight there.

No fun at all for them. I keep quality of life for her by joking, daft things and teasing her.
 
Seabreeze said:
I keep quality of life for her by joking, daft things and teasing her.
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Sounds like you are doing your very best for her. I am sure she really appreciates all you do. 🙂
 
Thanks
it's hard regarding meals and snacks as per above and then she goes off things...
 
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