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Options for the elderly

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I am confused by some of these responses.
The way I read the question is about replacing the cake with something more “filling” for someone on fixed doses of insulin and most of the suggestions are something low carb. Why?
Cake is not low carb so surely replacing with a full fat fruit yoghurt would be a reduction of carbs even for a higher carb yoghurt. Likewise with nuts.
I would be concerned these suggestions would be less carbs and could lead to a hypo.
Unless his BG is high, shouldn’t the options be for a similar level of carbs?
And, if his BG is high all the time, it maybe better to increase his basal.
 
Ok so yes it's trying to fill out his meals a bit more to try and help with the weight loss and to stop feeling hungry.

His specialist on Tuesday suggested more protein but I'm just looking for ways of taking on that protein.

His sugars are averaging 12 but she's told to try and bring it down to 10.

Apologies for any confusion
 
Well you know when you have ready sliced cooked meat in your fridge for sandwiches the general assumption is one slice per sandwich - so just bung 2 slices on. If a cooked meal is eg a chop, spuds and a veg - buy larger chops, eg most pork loin 'slices' sold in Tesco are so pathetically thin these days I despair - and often buy thicker cut bone-in proper chops instead. If there was a handy proper butchers shop I'd just ask the butcher for thicker whatever. So - what snacks does dad actually like - would he enjoy a lump of cheddar, or a decent slice of frittata - and would your mum be able to cook something like frittata?
 
So I got him some of these, he had half of one this afternoon and shot up from 14 to 23 tonight but I can't imagine it was this and must have been something else.

Just a thought, if he were to eat more and therefore need a bit more insulin, would that effect the benefits of eating more?

 
stuarta said:
So I got him some of these, he had half of one this afternoon and shot up from 14 to 23 tonight but I can't imagine it was this and must have been something else.

Just a thought, if he were to eat more and therefore need a bit more insulin, would that effect the benefits of eating more?

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That would only have been 6g carb so what else had he had.
It sounds as if his insulin is not in balance with the carbs he is eating, can you speak to his diabetic nurse to get some advice.
 
I didn't think it would be that, just seems a slow increase which we have seen from chocolate before but again I can't imagine there is enough chocolate in them to do that

Aside from that he had 2 tuna sandwiches, strawberries and ice cream, slice of fruit loaf and half a scone apparently so probably one of them
 
stuarta said:
I didn't think it would be that, just seems a slow increase which we have seen from chocolate before but again I can't imagine there is enough chocolate in them to do that

Aside from that he had 2 tuna sandwiches, strawberries and ice cream, slice of fruit loaf and half a scone apparently so probably one of them
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Probably not just the one thing but the total amount of carbs was more than the amount of insulin would be able to cope with. Has he been given any advice on the amount of carbs he should be having for the insulin dose or more appropriately how much insulin for the amount of carbs.
If his level is as high as that does he have a means of testing for ketones.
 
@stuarta If he had two tuna sandwiches rather than one, and a scone as an extra, it will be those. If he eats but doesn’t take the right amount of insulin then goes high, he won’t be able to use the food he’s eaten and won’t put on weight.
 
Ok thanks that's what I was wondering. Assumed it was one or a combined effort but wasn't sure about what would happen if he took extra insulin.
I've suggested to my mum that he increases it because he's eating more, but wasn't sure on the impact that would have with the whole weight thing.

So if it's not enough insulin, his sugars will go high like tonight, the body then fights it and the food will be wasted and weight not put on. If he took more insulin, his sugars wouldn't go high and therefore the food would go to putting weight on. Is that effectively correct?

Unfortunately we don't seem to be getting much from his nurses. One at the hospital has been great but just says "let him live out his golden years" and they don't seem to be concerned with his weight loss but obviously I'd still like him to keep it under as much control as possible but I'm having to rapidly understand it all.
 
Yes, that’s basically right @stuarta If he can keep his blood sugar in the right range and avoid going too high, he’ll be able to use the food he eats properly. Don’t just randomly increase his insulin because he could have a hypo if he were to have too much. It’s important you understand what you’re doing. You’ll have to count the carbs he’s eating and calculate the correct insulin dose for those carbs.
 
Great thank you and definitely, don't want to just willy nilly change it and trying to get them into a pattern so we can see what does what in some sense.

He's had Type 1 for around 25 years and unfortunately I've not focused on it much with him because he'd dealt with it and was on the Daphne scheme which appears to be a form of carb counting where he would change his dose depending on what he ate, or at least we thought he was. Back at Christmas he had a hypo which afterwards we think it was because he made a mistake and since then we put him in a libre with connections and being watching it closely. But from this, the hospital put him on a fixed dosage rather than the Daphne.

We then realised he'd been spiking for a while but his specialist wasn't really doing anything about it. Mix in with that mild vascular dementia, we are just watching him closely and the majority of the time he's ok, it's just finding ways to get more food in him and stop the weight loss. It now sounds as though some of the weight loss could be because of highs as well.
 
stuarta said:
Great thank you and definitely, don't want to just willy nilly change it and trying to get them into a pattern so we can see what does what in some sense.

He's had Type 1 for around 25 years and unfortunately I've not focused on it much with him because he'd dealt with it and was on the Daphne scheme which appears to be a form of carb counting where he would change his dose depending on what he ate, or at least we thought he was. Back at Christmas he had a hypo which afterwards we think it was because he made a mistake and since then we put him in a libre with connections and being watching it closely. But from this, the hospital put him on a fixed dosage rather than the Daphne.

We then realised he'd been spiking for a while but his specialist wasn't really doing anything about it. Mix in with that mild vascular dementia, we are just watching him closely and the majority of the time he's ok, it's just finding ways to get more food in him and stop the weight loss. It now sounds as though some of the weight loss could be because of highs as well.
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If he is on fixed doses then he will need to eat a particular amount of carbs and that will be what the hospital has said so the extra food shouldn't be too carb heavy otherwise his blood glucose will go high.
Foods like eggs, cheese, peanut butter, sugarfree jelly with cream, nuts, could be extras.
 
Yes, DAFNE is carb-counting 🙂 If you or somebody else helped him check the dose he’d calculated, maybe he could consider going back to carb-counting? If he needs a refresher, there are resources online , eg BERTIE:

Bertie Diabetes

bertiediabetes.com bertiediabetes.com

If he/you decide it’s easier and safer to have a fixed dose, you could always ask that the fixed dose is increased slightly to allow him to eat more carbs @stuarta
 
That was initially from them but then kind of left him to it. The main nurse at the diabetic unit at the hospital was the one that told him to eat what he wants and enjoy his "golden years" and then just correct as necessary. His specialist just says get your average from 12 to 10 and eat more protein but no really suggestions.

I have suggested unsalted nuts as something to snack on and also going to look at the Arla protein yoghurts for his breakfast but again I reckon we'll probably need to raise his morning insulin because it was lowered due to going low with just fruit and fibre. Bread and honey raised his sugars but he tends to stick to just fruit and fibre now
 
Correcting isn’t a great strategy for every day. It’s ok for ‘mistakes’ but allowing the blood sugar to go high then trying to get it down is a pain and won’t help his weight. Are you/he actually counting the carbs he’s eating?
 
Inka said:
Yes, DAFNE is carb-counting 🙂 If you or somebody else helped him check the dose he’d calculated, maybe he could consider going back to carb-counting? If he needs a refresher, there are resources online , eg BERTIE:

Bertie Diabetes

bertiediabetes.com bertiediabetes.com

If he/you decide it’s easier and safer to have a fixed dose, you could always ask that the fixed dose is increased slightly to allow him to eat more carbs @stuarta
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I could try but it would be my mum to check and unfortunately I don't think she could help count but maybe we could get there.

For now I think the simplest is fixed but increased slightly if we get him eating more
 
Inka said:
Correcting isn’t a great strategy for every day. It’s ok for ‘mistakes’ but allowing the blood sugar to go high then trying to get it down is a pain and won’t help his weight. Are you/he actually counting the carbs he’s eating?
Click to expand...
Yes I don't like the idea of living on correcting, especially as we've been told the highs is what's caused his dementia to a point. I don't live with them so it's just trying to find something that they can both manage easily
 
Sticking to weighed portions of cereal, etc, the same brand of sliced bread and same number of slices, and so on to keep regularity in his meals will help even if your mum can’t count the carbs.
 
Exactly that's what I'm aiming to do. It's just learning the finer points of what changes what and thanks again for all the help here.
 
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