Mum with diabetes

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lizhill

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Hi all, im new here and seeking some feedback on behalf of my mum who is 73yo type 2 diabetic.
We live 300 miles away and have general concerns that she is not managing her diabetes very much, but this turned into a reality on Sunday when we were visiting for Easter.
I would really appreciate some real life feedback having spent hours since Sunday with Dr Google ☹.
So on Friday we saw mum at my sisters and she was fine, but complaining only of a bit of sore throat.
On Sunday morning (according to my Dad) everything was normal, she got up, put some meat in the oven for lunch and was preparing for us coming.
At 1.30pm she went outside to my Dad working in the garden to say we were on the way and to open the gates on the drive so we could go straight in.
When we arrived 10 minutes later my mum was on the sofa, under a heated blanket shaking violently and saying she couldn't get warm after being in the shower. She asked for a hot water bottle and a lemsip from me and to say I'll have do do the dinner!
She had the lemsip and went to sleep on the sofa. At 3pm I asked if she wanted even just something little to eat given I was dishing out and she said no.
At 5pm she vomited, we asked what she had eaten and was told just a slice of toast and marmalade.
She slept constantly between these episodes.
At 6pm as we were preparing to leave she said she needed the toilet but she now was unable to get off the sofa. With an adult under each arm she managed to walk as far as the hall but then couldn't walk any further. She unfortunately soiled herself and then vomited again.
It took 3 adults 2 hours to get her up the stairs, she was a dead weight, completely unable to move anything herself. By this point she was also talking gibberish. It was very scary as she was completely out of her mind.
We got her in bed, when asked very direct questions such as name, what day is it etc she answered everything as expected.
We asked if she had taken her blood level that day and she said yes it was 10.2 (?) and yes she took her insulin too.
Since then she has fallen out of the bed Sunday night trying to get to toilet alone, but my Dad is reporting she is able to slowly get there herself today. She is sleeping 20 hours a day still.

She was very adamant on Sunday that we mustn't call any medical professionals, ambulance gp etc and I was too scared to go against her wishes.

My question to this group is really does this episode sound or look in any way related to her diabetes? She will not discuss with us any treatments or conversations she has with doctors, so im at my wits end trying to establish any facts.
Sorry its such a long post but hopefully it will provide some context

Thanks in advance

Liz xx
 
lizhill said:
Hi all, im new here and seeking some feedback on behalf of my mum who is 73yo type 2 diabetic.
We live 300 miles away and have general concerns that she is not managing her diabetes very much, but this turned into a reality on Sunday when we were visiting for Easter.
I would really appreciate some real life feedback having spent hours since Sunday with Dr Google ☹.
So on Friday we saw mum at my sisters and she was fine, but complaining only of a bit of sore throat.
On Sunday morning (according to my Dad) everything was normal, she got up, put some meat in the oven for lunch and was preparing for us coming.
At 1.30pm she went outside to my Dad working in the garden to say we were on the way and to open the gates on the drive so we could go straight in.
When we arrived 10 minutes later my mum was on the sofa, under a heated blanket shaking violently and saying she couldn't get warm after being in the shower. She asked for a hot water bottle and a lemsip from me and to say I'll have do do the dinner!
She had the lemsip and went to sleep on the sofa. At 3pm I asked if she wanted even just something little to eat given I was dishing out and she said no.
At 5pm she vomited, we asked what she had eaten and was told just a slice of toast and marmalade.
She slept constantly between these episodes.
At 6pm as we were preparing to leave she said she needed the toilet but she now was unable to get off the sofa. With an adult under each arm she managed to walk as far as the hall but then couldn't walk any further. She unfortunately soiled herself and then vomited again.
It took 3 adults 2 hours to get her up the stairs, she was a dead weight, completely unable to move anything herself. By this point she was also talking gibberish. It was very scary as she was completely out of her mind.
We got her in bed, when asked very direct questions such as name, what day is it etc she answered everything as expected.
We asked if she had taken her blood level that day and she said yes it was 10.2 (?) and yes she took her insulin too.
Since then she has fallen out of the bed Sunday night trying to get to toilet alone, but my Dad is reporting she is able to slowly get there herself today. She is sleeping 20 hours a day still.

She was very adamant on Sunday that we mustn't call any medical professionals, ambulance gp etc and I was too scared to go against her wishes.

My question to this group is really does this episode sound or look in any way related to her diabetes? She will not discuss with us any treatments or conversations she has with doctors, so im at my wits end trying to establish any facts.
Sorry its such a long post but hopefully it will provide some context

Thanks in advance

Liz xx
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Welcome to the forum
This is a worrying situation for all. I think despite her protests you need professional medical help as soon as possible. Things can change very quickly into something life threatening. You should at the very least call 111 and they will advise but I suspect they will say to go the A & E.
 
Yes she will completely refuse to go to A&E and like you I suspect that's exactly what 111 would say. She wouldn't be able to at the time anyway, there was no way we could have got her in a car.
I was trying to establish if she could be forced into hospital by a paramedic or not but my Dad said it wasn't worth it for him to ignore her wishes. At the end of the day he has to live with her day to day when we have gone home again.
 
lizhill said:
Yes she will completely refuse to go to A&E and like you I suspect that's exactly what 111 would say. She wouldn't be able to at the time anyway, there was no way we could have got her in a car.
I was trying to establish if she could be forced into hospital by a paramedic or not but my Dad said it wasn't worth it for him to ignore her wishes. At the end of the day he has to live with her day to day when we have gone home again.
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You could call the Diabetes UK helpline for advice, the number is at the top.
Also your Dad could speak to her GP or diabetic nurse.
How is she now?
 
Hi Liz - yes, worrying. Unfortunately without knowing what level her blood glucose was at that time - either when she couldn't get warm, or when she vomited (etc) nobody here can really tell you anything. Her blood glucose (BG) could quite easily have been a lot less than the earlier reading and under 4.0 which could mean she was hypoglycaemic - or a lot greater, hyper glycaemic, and if high enough she could easily have had ketones and if I were required to guess, that's what it sounds more like, to me. Dog tired and feeling nauseous are 2 symptoms I've certainly had more than once in my life, however I get a raging thirst then too - so as I say it is ONLY literally a slightly informed guess.

It absolutely isn't 100% 'normal' and 'just OK' though! - for background info - I'm 73 myself next week, had Type 1 diabetes since August 1972.

Try and get some more info out of mum - eg ask her if she actually knew what was up and I say that because I might know I've done something I shouldn't and have been thinking Oops, I should have done Y instead of X - but it's too complicated to explain to someone who hasn't a clue so I'll just say No don't ring 999 and I'll sort myself out once they leave me alone. No idea whatsoever whether your mum has Type 1, Type 2 treated by insulin or one of the other types of diabetes - but anyway if it was caused by too high or low BG it's very possible to have better control of day to day BG, which is what we're all striving for - so although the only person who can treat her diabetes is her - does she see her GP for day to day medical advice about it, or a hospital diabetes clinic and is her treatment 'regime' fully up to date? Modern insulins, carbohydrate counting/dose adjustment, or what?
 
There is no access to GP anymore in her area. Several practices have been taken over (outsourced) to a commercial care handling company. The people who answer the phone have 2 pathways, a team of remote gp s read the notes and either issue a prescription or advise go to A&E. My mum attended A&E under this guidance for a different issue in December and had an over 30 hour wait to be assessed so she refuses to go down that route again. She was hospitalised at that time due to blood in her faeces, that turned out to be burst ulcers in her stomach. Whilst in hospital she caught covid for first time, then e coli, then a UTI so had a very bad time of it. Due to issues wirh social care provision she was on a ward with severe dementia patients and her breaking point was when another patient thought the foot of her bed was as good a place as any to go to toilet, 1s and 2s.

I'm sorry I don't know the difference between 1 & 2, but this is something that has got worse with age, and was only moved from tablets to insulin and prick testing about a year ago. I asked my Dad to send me a list of all the drugs she has on prescription and after googling I recognise that Linogliptin 5mg is for the diabetes and others seem to be high blood pressure and a stomach one presumably for the ulcers.
She refuses to talk about any of her conditions and hangs up if I try to question her.
Once she's capable of talking again im trying to see if I can get a full medicine review, I've read on NHS that a pharmacist may be able to do that, avoiding an A&E trip to find a gp.
Diabetic nurse services stopped in covid, and she is monitored remotely so they don't need to provide staff. I understand the device she has for blood pricks sends readings, and if they change significantly in either direction it will trigger someone getting in touch.
 
I forgot to respond to the point about hyper vs hypo, thats interesting and ill look at that. Even delirious lying in the hall she was constantly asking for water, but nothing I read describes the severe complete lack of mobility and almost delirium talking.
At the moment I'm working on 3 possibilities, something diabetes, something to do with her cocktail of drugs reacting against each other , per my other post prescribes just get issued by a remote gp, without consideration to the other drugs. In the December episode she was issued antibiotics she us allergic to 3 times before we found a consultant she had been referred to in the past who issued a more specialist one she could tolerate. Or virus induced delirium. Im reading this can present in some covid cases, and she's had one previous episode like this on discharge from hospital with the triple infection of e coli covid and uti. Tbh given the mess they made of her last time im also wary of hospital, but its the only way to get face to face doctors.
 
It could have been very high ketosis. That’s very dangerous.
it happens when blood sugar levels get too high. Google DKA and see if any symptoms are similar. It requires medical attention!
 
Suzysheep said:
It could have been very high ketosis. That’s very dangerous.
it happens when blood sugar levels get too high. Google DKA and see if any symptoms are similar. It requires medical attention!
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Thanks, am I right in thinking from waking, the only way they can get higher is with food? She only had breakfast at 10am, and didn't start feeling unwell till 2pm with the worse symptoms by 6pm.
 
lizhill said:
Thanks, am I right in thinking from waking, the only way they can get higher is with food?
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Not enough insulin, illness, and 40 other factors as diverse as the weather can also make your blood sugar go up. The only way to find out if it’s related to diabetes is to check her blood sugar levels.
 
lizhill said:
Thanks, am I right in thinking from waking, the only way they can get higher is with food? She only had breakfast at 10am, and didn't start feeling unwell till 2pm with the worse symptoms by 6pm.
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Illness can cause high blood sugar too. Something like a tummy bug or flu-ey virus can really mess things up even if she’s not eating.

Could she afford a Libre sensor? That way she or a family member could scan it to check her blood sugar.
 
I've now learned from my Dad she's only ever been told to test 1x per day on waking.
 
lizhill said:
I've now learned from my Dad she's only ever been told to test 1x per day on waking.
Click to expand...
She should test when feeling unwell too. If it’s under 4 have fast acting carbs and check again in 15 minutes
 
Inka said:
Illness can cause high blood sugar too. Something like a tummy bug or flu-ey virus can really mess things up even if she’s not eating.

Could she afford a Libre sensor? That way she or a family member could scan it to check her blood sugar.
Click to expand...
I can get her anything, what is the advantages of such a device over the finger pricking? Just easier / more comfortable?
 
Inka said:
Illness can cause high blood sugar too. Something like a tummy bug or flu-ey virus can really mess things up even if she’s not eating.

Could she afford a Libre sensor? That way she or a family member could scan it to check her blood sugar.
Click to expand...
Is it £48 every 14 days?
 
Ive only got experience with type one, but my mum was given a Libra freestyle on prescription. She has to test multiple times a day though. It might be worth asking.
it might be a good idea to test regularly throughout the day.

I would try and persuade her to get checked out just to be safe.
 
Suzysheep said:
Ive only got experience with type one, but my mum was given a Libra freestyle on prescription. She has to test multiple times a day though. It might be worth asking.
it might be a good idea to test regularly throughout the day.

I would try and persuade her to get checked out just to be safe.
Click to expand...
I wish it was that easy. I called the company thats running gp services in the area today to see if she can speak to a diabetic nurse, but its not possible, only at her annual review which was December. The default answer is if you think its an emergency present at A&E. Also true for a go consultation, a phone appointment will be available in 10 working days. If you need to speak to someone sooner, present to A&E.
There is nothing in the world will push her back to the hospital.
 
That’s absolutely shocking! can you ring 111?
how are people getting emergency dr appointments on the day?
im sorry, it sounds like such a worry for you.
 
I think you should definitely get in touch initially with 111 and discuss the symptoms. My elderly Mum some years ago had symptoms very like the ones you describe - talking gibberish after vomiting and feeling ill. It turned out she had suffered a bleed on the brain. She had a couple of lucid days after the symptoms began, then things went downhill again and she had to be hospitalised in a neurological unit, where she recovered in time. I'm not saying that is what she is suffering from, but I do think you should seek advice.
 
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